Medicare Demonstration PPOs
Financial and Other Advantages for Plans, Few Advantages for Beneficiaries
Description:... Preferred provider org. (PPO) are more prevalent than other types of health plans, but, in 2003, only 6 PPOs contracted to serve Medicare beneficiaries (BE) in Medicare+Choice. The Centers for Medicare & Medicaid Services (CMS) initiated 2 demonstrations that include a total of 34 PPOs. This study: (1) describes how CMS used its statutory authority to conduct the 2 demo's., (2) assessed the extent to which demo. PPOs (DP) expanded access to Medicare health plans & attracted enrollees, (3) compared CMS's est. of out-of-pocket costs that BE incurred in DP with those of other types of coverage, incl. fee-for-service Medicare, M+C plans, & Medigap policies, & (4) determined the effects of DP on Medicare spending. Charts & tables.
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