Purpose Chiropractic care is covered under Medicare, but the scope of services is restricted. The Demonstration of Expanded Coverage of Chiropractic Services under Medicare projected that expanded services would cost Medicare up to $1.15 billion annually. The potential expansion of chiropractic services under Medicare remains controversial. Advocates for expansion cite clinical effectiveness an...

Dear Editor: Despite mounting evidence that hospice provides highvalue, high-quality care, many eligible Medicare beneficiaries do not enroll, and lengths of hospice stay remain short. Policymakers have considered changes to Medicare policies to encourage hospice use, but there are persistent concerns about the impact of expanding services on the long-term financial solvency of the program. In ...

Medicare Advantage: Issues, Insights, and Implications for the Future Paul Cotton, Joseph P. Newhouse, PhD, Kevin G. Volpp, MD, PhD, A. Mark Fendrick, MD, Susan Lynne Oesterle, Pat Oungpasuk, Ruchi Aggarwal, Gail Wilensky, PhD, and Kathleen Sebelius Editorial    S-2 D.B. Nash, and A.Y. Schwartz The History, Impact, and Future of the Medicare Advantage Star Ratings System    S-3 P. Cotton Medica...

The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, MA plans have, for the past six years, been paid more for their enrollees than they would be expected to cost in traditional fee-for-service Medicare. Payments to MA plans in 2009 are projected to be 13 percent greater than the corresponding costs in traditional M...

Under Medicare's Part B program, wide variations are found in average reimbursements for physicians' services by demographic and geographic characteristics of the beneficiaries. Average reimbursements per beneficiary enrolled in the program depend upon the percentage of enrolled persons who exceed the deductible and receive reimbursements, the average allowed charge per service, and the number ...

Medicare has lagged behind the private sector in its reliance on managed care, which, properly done, has the potential to restrain budget growth and enhance quality. This paper addresses how the Medicare fee-for-service program--traditional Medicare--might apply managed care techniques. It first discusses the institutional constraints Medicare faces in implementing managed care techniques and t...

(MCBS) tracks health care expenditures for 12,000 beneficiaries. The survey is unique because it combines survey data with Medicare administrative data to give a detailed portrait of health care spending for Medicare beneficiaries. The MCBS provides health care expenditures for the Medicare population by service and payer, and it allows for analysis by demographic and socioeconomic characterist...

A ubiquitous form of government intervention in insurance markets is to provide compulsory, but partial, public insurance coverage and to allow voluntary purchases of supplementary private insurance. This paper investigates the effects of such programs on insurance coverage for the risks not covered by the public program, using the example of the US Medicare program. I find that Medicare does n...

The Medicare rules governing the supervision of diagnostic tests have changed over time, as have the skills and training of radiologist assistants, who may have the education and clinical skills to deliver surgical and invasive procedures often performed as part of a radiology practice. However, for the purposes of Medicare coverage, radiologist assistants are not yet recognized as independent ...