A tale of four cities: Medicare reform and competitive pricing

Citation
B. Dowd et al., A tale of four cities: Medicare reform and competitive pricing, HEAL AFFAIR, 19(5), 2000, pp. 9-29
Citations number
21
Categorie Soggetti
Public Health & Health Care Science
Journal title
HEALTH AFFAIRS
ISSN journal
02782715 → ACNP
Volume
19
Issue
5
Year of publication
2000
Pages
9 - 29
Database
ISI
SICI code
0278-2715(200009/10)19:5<9:ATOFCM>2.0.ZU;2-8
Abstract
The current payment system for Medicare+Choice (M+C) plans is based on pric es calculated from administrative records. This system has been criticized as arbitrary, inefficient, and unfair. Most Medicare reform proposals would replace the current payment system with some form of competitive pricing. However, efforts over the past five years to demonstrate competitive pricin g for M+C plans have been blocked repeatedly by Congress, even when the dem onstrations were directly responsive to a congressional mandate. In the abs ence of political support, a demonstration of competitive pricing may be in feasible, and Congress could be forced to take the risky step of implementi ng broad Medicare reforms with very little information about their effects.