The Affordable Care Act has altered payment policy for private Medicare Advantage (MA) plans, with the goal of lowering costs closer to the level in traditional Medicare. Using newly available information on 2009 MA plan costs, this analysis com­pares plans' estimates of per capita costs for providing Parts A and B benefits to their enrollees, on a risk-adjusted basis, against what government d...

In a reversal of recent trends, private fee-for-service (PFFS) enrollment fell dramatically in rural areas in early 2010. As a result, Medicare Advantage (MA) enrollment in rural areas (excluding other prepaid plans) fell slightly in early 2010 for the first time in years. The dramatic drop in PFFS enrollment was offset by increases in enrollment in preferred provider organization (PPO) and hea...

The costs of providing benefits to enrollees in private Medicare Advantage (MA) plans are slightly less, on average, than what traditional Medicare spends per beneficiary in the same county. However, MA plans that are able to keep their costs comparatively low are concen­trated in a fairly small number of U.S. counties. In the 25 counties where the cost differences between MA plans and traditio...

The Medicare Advantage (MA) program offers beneficiaries a choice of private health plans as alternatives to the traditional fee-for-service Medicare program. MA plans potentially provide additional value, but as plan choices have proliferated, consumers contemplating their options have had difficulty understanding how they differ. Through "standardization" more consistent types of information ...

There is a considerable amount of controversy about the model(s) of comparative advantage and its applicability to international business, in particular as a guide to the success of nations and/or firms in international markets. This perception (or understanding) of inapplicability of the model(s) of comparative advantage has lead international business experts to develop new models, or what ma...

Competition among private Medicare Advantage (MA) plans is seen by some as leading to lower premiums and expanded benefits. But how much competition exists in MA markets? Using a standard measure of market competition, our analysis finds that 97 percent of markets in U.S. counties are highly concentrated and therefore lacking in significant MA plan competition. Competition is considerably lower...

Hayes's [1985] contained-stuff and piece-of-stuff ontologies for liquids sho w that it is often desirable or necessary to shift to a proper ontological abstraction i n reasoning about complex physical systems . The importance of such an ontological shift becomes clear in the resulting explanation of why the system has the manifested behavior . In this paper, we identify a charge-carrier (CC) on...

In December 2008, 8 in 10 rural Medicare beneficiaries had creditable prescription drug coverage, and over half of these beneficiaries were enrolled in a prescription drug coverage option offered through the Medicare Part D program (Figure 1). However, the array of coverage patterns for rural and urban beneficiaries is strikingly different. Rural beneficiaries are more likely to enroll in stand...

This paper studies the role of Medicare's premium policy in sorting beneficiaries between traditional Medicare (TM) and managed care plans in the Medicare advantage (MA) program. Beneficiaries vary in their demand for care. TM fully accommodates demand but creates a moral hazard inefficiency. MA rations care but disregards some elements of the demand. We describe an efficient assignment of bene...