New on the Web 15: November 2002
We've collected information on several new reports and other resources available on the Web that we hope you'll find interesting and useful. Descriptions and links appear below.
AARP Public Policy Institute: "What Share of Beneficiaries' Total Health Care Costs Does Medicare Pay?"
Center for Studying Health System Change: "Kinder and Gentler: Physicians and Managed Care, 1997-2001"
Commonwealth Fund: "Average Out-of-Pocket Health Care Costs for Medicare+Choice Enrollees Increase Substantially in 2002," "Trends in Medicare+Choice Benefits and Premiums, 1999-2002"
Community Catalyst: "A Guide to Organizing Community Forums"
Kaiser Family Foundation: "Medicare and Prescription Drugs"
Kaiser Commission on Medicaid and the Uninsured: "Medicaid and the Prescription Drug Benefit: Cost Containment Strategies and State Experiences," "Medicaid and Prescription Drugs"
Mathematica Policy Research: "Children with Special Health Care Needs in Commercial Managed Care: Patterns of Service Use and Cost"
National Council of La Raza and HHS: "Protect Your Family's Health…with Confidence"
Public Citizen: "Medicare Privatization: The Case Against Relying on HMOs and Private Insurers to Offer Prescription Drug Coverage"
AARP Public Policy Institute
Although Medicare provides important coverage for hospital, physician, and other services, its cost-sharing requirements are sometimes substantial, and its benefit package is lacking in several key areas.
What Share of Beneficiaries' Total Health Care Costs Does Medicare Pay? projects total personal health care expenditures in 2000 for the Medicare population in the aggregate. This Data Digest identifies the sources of payment for these expenditures and examines how sources for elderly beneficiaries differ from those for younger beneficiaries with disabilities. (September 2002)
Center for Studying Health System Change
Kinder and Gentler: Physicians and Managed Care, 1997-2001 finds that, despite the backlash against managed care, an overwhelming majority of physicians continue to contract with managed care health plans. It also found that physician practices moved away from using direct financial incentives to influence doctors' clinical decision-making, but they did experience an increase in the overall influence of treatment guidelines and other practices commonly associated with managed care. (November 2002)
Commonwealth Fund
Average Out-of-Pocket Health Care Costs for Medicare+Choice Enrollees Increase Substantially in 2002 updates an earlier report that focused on the period from 1999-2001. The Issue Brief finds that average out-of-pocket costs for Medicare+Choice enrollees in 2002 are up 24 percent from 2001 and 83 percent from 1999. The report also finds that enrollees in poor health faced the steepest cost increases. (November 2002)
Trends in Medicare+Choice Benefits and Premiums, 1999-2002 examines broad trends in benefits and premiums since 1999 and analyzes 2002 benefit packages, focusing on changes that are likely to affect chronically ill beneficiaries who require more services. The authors also analyze the patterns in plan benefit and premium changes since 1999 and speculate about what these might reveal about health plan strategies. (November 2002)
Community Catalyst
A Guide to Organizing Community Forums was compiled to provide individuals and consumer groups with sets of guiding questions to organize more effective community forums. The guiding questions deal with several general concerns that arise when planning a forum, and each section includes brief checklists that should prove helpful during the different stages of forum organizing efforts. (July 2002)
Kaiser Family Foundation
Medicare and Prescription Drugs is an updated fact sheet that details current sources of prescription drug coverage among Medicare beneficiaries and that provides current data on prescription drug use and spending. It also discusses the characteristics of beneficiaries who lack drug coverage and the implications of being without such coverage. (October 2002)
Kaiser Commission on Medicaid and the Uninsured
Medicaid and Prescription Drugs is an updated fact sheet that summarizes the latest statistics and trends regarding the role of Medicaid in providing prescription drug coverage. (October 2002)
Medicaid plays a fundamental role in the provision of outpatient prescription drugs to low-income people, but all state Medicaid programs face the challenge of managing pharmacy expenditures in this difficult economic climate. Medicaid and the Prescription Drug Benefit: Cost Containment Strategies and State Experiences provides background information on Medicaid and its prescription drug benefit. It also provides examples of how states are using the cost containment mechanisms at their disposal, and it addresses issues surrounding beneficiary access to outpatient drugs. (September 2002)
Mathematica Policy Research
Most studies on the costs of care for children with special health care needs (CSHCN) have focused on children enrolled in Medicaid despite the fact that most of these children are privately insured. CSHCN who are enrolled in commercial, employer-based health insurance may be at high risk for inadequate access to necessary health services.
Children with Special Health Care Needs in Commercial Managed Care: Patterns of Service Use and Cost provides new information on patterns of service use and cost for 30,000 CSHCN enrolled in private managed care plans in 1999-2000. (September 2002)
National Council of La Raza and HHS
Protect Your Family's Health…with Confidence is a bilingual booklet that explains how parents can receive low-cost or free health coverage. It examines Medicaid and SCHIP and answers questions regarding children's health coverage when a parent is not a U.S. citizen. The booklet also serves as a guide for families with concerns about immigration status. (Fall 2002)
Public Citizen
Medicare Privatization: The Case Against Relying on HMOs and Private Insurers to Offer Prescription Drug Coverage examines government and private sector research on the Medicare program's current experience with private sector plans. The report finds that coverage offered through private insurers would be unreliable, inefficient, and confusing to beneficiaries. It also concludes that private plans would not be able to negotiate the steep drug price discounts that would be achievable if Medicare offered a prescription drug benefit directly. (September 2002)
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