Enrollment in Medicare Advantage (MA) plans in rural areas grew more than 50% in the first three quarters of 2007 and has more than tripled since the inception of the MA program at the beginning of 2006. However, rural enrollment remains well below urban enrollment as a percentage of the eligible population. This brief updates early findings from analysis of the Medicare+Choice/MA program prese...

This is a case study of industrial systems development. In the project studied, an advanced computer application was developed with the intention of supporting complex, cooperative work. The project participants all viewed the emerging computer application in context. However, different contexts were used by each group of actors. Since the application was placed in contexts well known by the pa...

The Medicare Modernization Act of 2003 explicitly increased Medicare payments to private Medicare Advantage (MA) plans. As a result, every MA plan in the nation is paid more for its enrollees than they would have been expected to cost in traditional fee-for-service Medicare. The authors calculate that payments to MA plans in 2008 will be 12.4 percent greater than the corresponding costs in trad...

abstract in the current decade the third world's countries are using of development rural tourism approach to improve indexes of development. in iran due to multiplicity of rural area using of this strategy is important. analysis the condition of host area for achieving positive tourism impacts is necessary. in this paper, the challenges and opportunities on developing rural tourism is distingu...

When faced with a variable environment, organisms may switch between different strategies according to some probabilistic rule. In an infinite population, evolution is expected to favor the rule that maximizes geometric mean fitness. If some environments are encountered only rarely, selection may not be strong enough for optimal switching probabilities to evolve. Here we calculate the evolution...

With higher payments and expanded private-plan authority, Medicare Advantage (MA) has caused the market to grow. One in three Medicare beneficiaries with Part D now gets this coverage through MA. Analysis of the sources of and reasons for enrollment growth suggest a troubling report card. Clearly, the Medicare Modernization Act (MMA) has expanded choice and the private-sector role. But it also ...