Previewing Medicare Advantage

September 22, 2004

Congress made major changes in the Medicare managed care program, now named “Medicare Advantage,” affecting plans and beneficiaries in 2005 and 2006. The Department of Health and Human Services (HHS) has proposed regulations to implement this part of the new law, and comments on the draft regulations are due by October 4, 2004.

What are the key changes Congress legislated, and how are they handled in the proposed regulations? What are the major areas that the government is seeking comment on? What new managed care and private plan options will be available to beneficiaries, and when will they start? Will the new options provide measurable advantages for beneficiaries? Will there be differences between urban and rural areas?

To help examine these questions and others, the Alliance for Health Reform and The Commonwealth Fund cosponsored a September 22, 2004 briefing. Panelists were: Philip Doerr, Deputy Director, Medicare Advantage Group, Center for Beneficiary Services within HHS; Michael Hash, Principal, Health Policy Alternatives; Jack Ebeler, President and CEO of the Alliance of Community Health Plans; Brian Biles, George Washington University School of Public Health and Health Services; and Karen Ignagni, President and CEO of America’s Health Insurance Plans. Barbara Cooper of The Commonwealth Fund made brief remarks and Ed Howard of the Alliance moderated the discussion.

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