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来源类型Journal Article
规范类型其他
Why Medicare Advantage Plans Pay Hospitals Traditional Medicare Prices
Robert A. Berenson; Jonathan Sunshine; David Helms; Emily Lawton
发表日期2015-08-01
出版年2015
语种英语
概述Surveying senior hospital and health plan executives, we find that, contrary to common assumptions in the policy community, Medicare Advantage plans nominally pay hospitals only 100–105 percent of traditional Medicare rates and, in real economic terms, possibly less. Respondents broadly identified three primary reasons for near–payment equivalence: statutory and regulatory provisions that limit out-of-network
摘要
Surveying senior hospital and health plan executives, we find that, contrary to common assumptions in the policy community, Medicare Advantage plans nominally pay hospitals only 100–105 percent of traditional Medicare rates and, in real economic terms, possibly less. Respondents broadly identified three primary reasons for near–payment equivalence: statutory and regulatory provisions that limit out-of-network payments to traditional Medicare rates, de facto budget constraints MA plans face because of the need to compete with traditional Medicare, and market equilibrium that permits relatively lower MA rates as long as commercial rates remain well above traditional Medicare rates. We explore policy implications of these findings.
主题Health and Health Policy
URLhttps://www.urban.org/research/publication/why-medicare-advantage-plans-pay-hospitals-traditional-medicare-prices
来源智库Urban Institute (United States)
资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/478982
推荐引用方式
GB/T 7714
Robert A. Berenson,Jonathan Sunshine,David Helms,et al. Why Medicare Advantage Plans Pay Hospitals Traditional Medicare Prices. 2015.
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