
Medicare—the federal health insurance program for adults aged 65 and older and for younger people with permanent disabilities—consists of four parts. Part A, the hospital insurance (HI) program, covers inpatient hospital, skilled nursing, and some home health care. For beneficiaries who choose to enroll and pay a monthly premium, Part B, the supplementary medical insurance (SMI) program, covers outpatient services like physician, laboratory, outpatient hospital, and medical equipment. Medicare Advantage, or Part C, lets beneficiaries choose to receive their Part A and B benefits through participating private health plans. Part D provides prescription drug coverage through private plans for beneficiaries who enroll and pay the required premium. In 2007, over 44 million people were covered by the Medicare program.
The Forum's body of work on Medicare issues focuses on the mechanics of its fee-for-service and managed care payment policies, how the payment policies affect the participation of providers and plans, the services available to its beneficiaries, and private payers and the health care market. The Forum also examines the quality assurance mechanisms Medicare has implemented, the role of Medicare in shaping the health care delivery system, and the impact of the Medicare program on the federal budget.
Forum Session
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January 27, 2012
Improving Care for Dual Eligible Medicare-Medicaid Beneficiaries: One Size Does Not Fit All
Forum Session
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December 9, 2011
Medicare Supplemental Coverage: Weighing the Consequences and Trade-Offs for Medicare Spending and Beneficiaries
Forum Session
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December 2, 2011
Mission Possible? Saving on Health Care Costs by Reducing Unnecessary Services
Forum Session
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October 28, 2011
Preventing Hospital Readmissions: How Can Care Transitions for Medicare Beneficiaries Be Improved?
Special Briefing
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October 21, 2011
Revisiting Financing and Delivery of Care to Duals: One Size May Not Fit All
Forum Session
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October 7, 2011
Graduate Medical Education: Producing the Right Workforce for Tomorrow?
Background Paper
No. 82
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September 14, 2011
Aligning Graduate Medical Education with Public Policy
Forum Session
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July 29, 2011
Fiscal Pressure and Hospital Financial Position
Forum Session
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July 22, 2011
Medical Care for the Elderly Living at Home: Home-Based Primary Care (HBPC) and Hospital-at-Home Programs
The Basics
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June 21, 2011
Medicare's Sustainable Growth Rate
Site Visit
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May 31–June 2, 2011
Rocky Mountain Highs and Lows: Efforts to Improve Health and Reduce Costs in Denver
Forum Session
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May 20, 2011
Medicare's Vision of Accountable Care Organizations: Will Providers Have the Same View?
Forum Session
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May 13, 2011
Boomers and the Budget: Implications of an Aging Society
Fundamentals Briefing
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April 1, 2011
Health Policy Essentials: The Fundamentals of Long-Term Services and Supports
Forum Session
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April 1, 2011
Physician Self-Referral and Health Care Utilization
Issue Brief
No. 841
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March 28, 2011
Medicare's Bundling Pilot: Including Post-Acute Care Services
Forum Session
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March 18, 2011
Caring for Patients with Advanced and Serious Illnesses: Changing Medical Practice and Patient Expectations
Fundamentals Briefing
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March 4, 2011
Health Policy Essentials: The Fundamentals of the SGR: Getting a Fix on Medicare’s Physician Spending
Fundamentals Briefing
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February 18, 2011
Health Policy Essentials: The Fundamentals of Health Care Spending, Growth, and Managing Costs
Briefing Book
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February 11, 2011
Health Policy Essentials
Fundamentals Briefing
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February 11, 2011
Health Policy Essentials: The Fundamentals of Medicare, Medicaid, and CHIP
The Basics
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February 7, 2011
The Medicare Drug Benefit Coverage Gap
The Basics
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January 24, 2011
Medicare
The Basics
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January 24, 2011
The Medicare Drug Benefit (Part D)
Forum Session
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December 10, 2010
Insurer-Provider Payment Negotiations: Implications for Health Spending
Forum Session
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October 8, 2010
The Cost of Hospital Care
Background Paper
No. 79
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September 28, 2010
The Primary Care Safety Net: Strained, Transitioning, Critical
The Basics
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September 23, 2010
Medicare Part B Premiums and Social Security Benefits
Forum Session
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July 23, 2010
Medicare and Medicaid Dual Eligibles: Meeting Diverse, Complex, and Costly Needs
Issue Brief
No. 838
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July 22, 2010
Medicare Physician Fees: The Data Behind the Numbers
Forum Session
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July 22, 2010
Focus on Reform: How a Law Becomes a Reg - Regulatory Processes to Implement Legislation
Forum Session
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July 16, 2010
Focus on Reform: Health Care Safety Net-Related Provisions
Forum Session
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June 25, 2010
Focus on Reform: Public Health Provisions
Forum Session
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June 21, 2010
Health Care Cost Drivers in Massachusetts: Lessons for Federal Policymakers
Background Paper
No. 75
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June 4, 2010
Health Care Shortage Designations: HPSA, MUA, and TBD
Site Visit
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June 2–4, 2010
Heath Care Spending: Why Is Miami an Outlier?
Forum Session
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May 21, 2010
Geographic Variation in Health Care Spending: What Do We Know, and Why Does It Matter?
The Basics
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March 29, 2010
The State Health Insurance Assistance Program (SHIP)
Small-Group Session
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March 5, 2010
Medicare Fee Schedule: What’s the RUC Got to Do With It?
Forum Session
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February 26, 2010
Assessing and Ensuring Health Plan Provider Network Adequacy
Forum Session
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January 14, 2010
Health Information Exchange: Building the Infrastructure for Better Care
Forum Session
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November 13, 2009
Health Care Provider Consolidation and Reform
Forum Session
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October 30, 2009
Prevention and Early Detection of Health Care Fraud, Abuse, and Waste
The Basics
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October 14, 2009
Discharge Planning and Medical Social Services in Fee-for-Service Medicare
Background Paper
No. 70
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August 31, 2009
Coverage and Payment for Prescription Drugs Under Medicare Part B: A Complex Patchwork
Issue Brief
No. 833
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July 31, 2009
The Medicare Drug Benefit: Update on the Low-Income Subsidy
The Basics
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July 29, 2009
Paying the Bills: Medicare Administrative Contractors
Forum Session
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May 29, 2009
High Rehospitalization Rates: Causes, Costs, and Accountability
Forum Session
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May 1, 2009
Great Expectations: Managing the Centers for Medicare & Medicaid Services
Site Visit
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April 17 & August 7, 2009
Coordinating Care for People with Multiple Chronic Conditions: The Guided Care Model and Other Innovative Approaches
Forum Session
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April 3, 2009
Promising Models of Care Coordination for Adults with Multiple Chronic Conditions: Getting Closer to the Holy Grail?
Forum Session
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March 27, 2009
Coordinating Care for Adults with Multiple Chronic Conditions: Searching for the Holy Grail
The Basics
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February 12, 2009
Relative Value Units (RVUs)
Fundamentals Briefing
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February 6, 2009
Medicaid, Employers, and Medigap: Wrapping Around Medicare
Fundamentals Briefing
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January 30, 2009
The World of Prescription Drugs: Approvals, Pricing, and Purchasing
Fundamentals Briefing
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January 15–16, 2009
Understanding Medicare and Medicaid: Fundamentals and Issues for the New Congress
Forum Session
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December 11, 2008
Medicare and Medicaid Demonstrations: Experimenting for the Future
Forum Session
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November 13, 2008
Medical Imaging Services: Utilization, Spending, and Appropriateness
Issue Brief
No. 827
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November 3, 2008
Primary Care Physician Supply, Physician Compensation, and Medicare Fees: What Is the Connection?
Forum Session
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October 30, 2008
Exploring Comparative Effectiveness: Fundamentals and Controversies of Cost-Effectiveness Analysis
Forum Session
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August 1, 2008
Medicare's Hospice Benefit: In the Spotlight
The Basics
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July 30, 2008
Medicare Demonstrations
Background Paper
No. 63
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July 22, 2008
The Fundamentals of Medicare Demonstrations
Small-Group Session
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May 2, 2008
Physician Income and Medical Practice Differences Across Specialties: Should Medicare Care?
Forum Session
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April 11, 2008
Employer Use of Medicare Private Fee-for-Service Plans as a Retiree Health Benefit
Forum Session
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January 17, 2008
Running Up the Health Care Tab: Will We Have Buyer's Remorse?
Forum Session
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December 14, 2007
The Ethics in Patient Referrals Act: The Stark Law and the Practice of Medicine
Forum Session
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November 30, 2007
Medicare Advantage Special Needs Plans Reauthorization: What Should Congress Consider?
Forum Session
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October 19, 2007
Medicare Drug Utilization Management: Balancing Cost, Convenience, and Access
Background Paper
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September 24, 2007
Medicare Advantage Payment Policy
Issue Brief
No. 825
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September 10, 2007
Physician Profiling: Can Medicare Paint an Accurate Picture?
Background Paper
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August 21, 2007
Medicare's Use of Risk Adjustment
Forum Session
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July 13, 2007
What Can Physician Profiling Do for Medicare?
Forum Session
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June 22, 2007
Medicare Advantage in 2007: What Are the Choices?
Forum Session
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June 1, 2007
Getting the Fees "Right" and Medicare Physician Spending
Background Paper
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May 9, 2007
The Prescription Drug Safety Net: Access to Pharmaceuticals for the Uninsured
Fundamentals Briefing
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February 22–23, 2007
Understanding Medicare and Medicaid: Fundamentals and Issues for the New Congress
Meeting Report
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December 6, 2006
A Report from the Forum Session "Complexity, Coordination and Compromise: States and the Medicare Drug Benefit" (August 4, 2006)
Background Paper
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November 27, 2006
Medicare and Mental Health: The Fundamentals
Forum Session
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November 17, 2006
The Medicare PDP Market: Build It and the Plans Will Come
Issue Brief
No. 818
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November 10, 2006
Updating Medicare's Physician Fees: The Sustainable Growth Rate Methodology
Issue Brief
No. 817
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November 8, 2006
The Nuts and Bolts of PDPs
Forum Session
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October 13, 2006
Medicare Physician Spending: Past as Prologue?
Issue Brief
No. 815
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October 9, 2006
Medicare Physician Payments and Spending
Forum Session
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August 4, 2006
Complexity, Coordination and Compromise: States and the Medicare Drug Benefit
Issue Brief
No. 813
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August 2, 2006
A Closer Look at the Medicare Part D Low–Income Benchmark Premium: How Low Can It Go?
Forum Session
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March 31, 2006
Medicare Provider Payments: Proposals from MedPAC and the Administration
Forum Session
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March 17, 2006
Physician Spending Growth: Do We Get What We Pay For?
Background Paper
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February 8, 2006
Health Benefits in Retirement: Set for Extinction?
Forum Session
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November 18, 2005
Medicare Advantage Special Needs Plans: A New Opportunity for Integrated Care?
Issue Brief
No. 808
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November 11, 2005
Medicare Advantage SNPs: A New Opportunity for Integrated Care?
Forum Session
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October 21, 2005
Medicare Health Support: Working with Physicians?
Meeting Report
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September 22, 2005
A Report from the Forum Session “Implementing the Medicare Prescription Drug Benefit: Continuing Challenges for States”
Issue Brief
No. 804
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July 13, 2005
Specialty Hospitals: Can General Hospitals Compete?
Forum Session
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July 12, 2005
Implementing the New Medicare Drug Benefit: Continuing Challenges For States
Forum Session
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June 10, 2005
How Will They Know? Where Will They Go? Education and Outreach for the Medicare Drug Benefit
Forum Session
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April 28, 2005
Understanding Medicare Advantage Bidding and Payment: Effects on Plan Choice and Beneficiary Premiums
Site Visit
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March 29–31, 2005
Exploring California's Rural Health System: From the Redwood Forests to the Baja Border
Fundamentals Briefing
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January 13–14, 2005
Understanding Medicare and Medicaid: Fundamentals and Issues for the New Congress
Forum Session
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December 1, 2004
Implementing the Formulary Requirements Under the New Medicare Prescription Drug Benefit
Forum Session
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September 17, 2004
From 10 to 50: Options for Medicare Advantage Plan Regions
Meeting Report
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August 31, 2004
A Report from the Forum Session “Implementing the New Medicare Drug Benefit: Challenges and Opportunities for States”
Forum Session
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July 22, 2004
Implementing the New Medicare Drug Benefit: Challenges and Opportunities for States
Issue Brief
No. 797
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May 10, 2004
Medicare's Chronic Care Improvement Pilot Program: What Is Its Potential?
The Basics
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April 26, 2004
State Pharmacy Assistance Programs
Forum Session
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April 13, 2004
Implementing the MMA: Insights from Two Seasoned Administrators
Forum Session
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February 6, 2004
Evidence- and Value-Based Approaches to Drug Formularies: What Role Will They Play in the Medicare Prescription Drug Benefit?
Background Paper
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November 14, 2003
Bridging Silos, Part I: Linkages among the DI, SSI, Medicare, and Medicaid Programs
Background Paper
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November 14, 2003
Bridging Silos, Part II: DI, SSI, Medicare, and Medicaid Issues and Initiatives
Forum Session
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October 22, 2003
Dually Eligible for Medicare and Medicaid: Two for One or Double Jeopardy?
Issue Brief
No. 794
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September 30, 2003
Dually Eligible for Medicare and Medicaid: Two for One or Double Jeopardy?
Forum Session
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September 25, 2003
The Medicare Prescription Drug Proposals and Health Insurance Risk
Background Paper
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September 15, 2003
Shaping Public Programs through Medicare, Medicaid, and SCHIP Waivers: The Fundamentals
Issue Brief
No. 793
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September 4, 2003
The Medicare Prescription Drug Proposals and Health Insurance Risk
Forum Session
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July 30, 2003
The Geography of Medicare: Explaining Differences in Payment and Costs
Forum Session
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July 9, 2003
Preferred Provider Organizations: Bringing the Mainstream to Medicare?
Issue Brief
No. 792
—
July 3, 2003
The Geography of Medicare: Explaining Differences in Payment and Costs
Forum Session
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March 26, 2003
Medicare and Chronic Conditions: Breaking Down Barriers to Better Care
Fundamentals Briefing
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January 23–24, 2003
Understanding Medicare and Medicaid: Fundamentals and Issues for the New Congress
Forum Session
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November 25, 2002
A Medicare Prescription Drug Benefit: Exploring Issues Raised in a CBO Report
Site Visit
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November 12–14, 2002
The Medicare and Medicaid Intersection: Caring for Arizona's Seniors
Forum Session
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October 2, 2002
Medigap: Prevalence, Premiums, and Opportunities for Reform
Issue Brief
No. 782
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September 9, 2002
Medigap: Prevalence, Premiums, and Opportunities for Reform
Forum Session
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July 18, 2002
Managing Advanced Illness: A Quality and Cost Challenge to Medicare, Medicaid, and Private Insurers
Forum Session
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July 12, 2002
Average Wholesale Price for Prescription Drugs: Is There a More Appropriate Pricing Mechanism?
Small-Group Session
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July 10, 2002
Modernizing Medicare: The Homebound Rule and Next Steps
Issue Brief
No. 779
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June 20, 2002
Managing Advanced Illness: A Quality and Cost Challenge to Medicare, Medicaid, and Private Insurers
Issue Brief
No. 775
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June 7, 2002
Average Wholesale Price for Prescription Drugs: Is There a More Appropriate Pricing Mechanism?
Forum Session
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April 26, 2002
Pharmacy Benefits: New Concepts in Plan Design
Issue Brief
No. 772
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March 8, 2002
Pharmacy Benefits: New Concepts in Plan Design
Site Visit
—
March 4–5, 2002
Transitions along the Continuum of Care: Elderly and Disabled Persons in New York
Background Paper
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January 25, 2002
From Diagnosis to Payment: The Dynamics of Coding Systems for Hospital, Physician, and Other Health Services
Site Visit
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January 8–11, 2002
Managed Care: As Good As It Gets? (Los Angeles)
Forum Session
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November 28, 2001
Reconsidering Medicare+Choice: What Options Remain?
Forum Session
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November 2, 2001
Medicare Coverage: Lessons from the Past, Questions for the Future
Background Paper
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August 2001
Medicare Coverage: Lessons from the Past, Questions for the Future
Issue Brief
No. 765
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July 9, 2001
Pharmacy Benefit Managers: A Model for Medicare?
Forum Session
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July 9, 2001
Pharmacy Benefit Managers: A Model for Medicare?
Issue Brief
No. 764
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June 22, 2001
Federal and State Perspectives on GME Reform
Forum Session
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June 22, 2001
Federal and State Perspectives on GME Reform
Site Visit
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May 5, 2001
Health Care Financing Administration Central Office
Issue Brief
No. 762
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April 25, 2001
State-Based Pharmaceutical Assistance Programs: Temporary Fix or Lessons for Medicare?
Forum Session
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April 25, 2001
State-Based Pharmaceutical Assistance Programs: Temporary Fix or Lessons for Medicare?
Forum Session
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February 23, 2001
Reflections on HCFA: Former Administrators Speak Their Minds
Issue Brief
No. 758
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September 8, 2000
Medicare+Choice: Where to from Here?
Forum Session
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September 8, 2000
Medicare+Choice: Where to from Here?
Issue Brief
No. 756
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June 16, 2000
HCFA's Outpatient PPS: Finally Ready to Roll?
Forum Session
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June 16, 2000
HCFA's Outpatient PPS: Finally Ready to Roll?
Workshop
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April 27–28, 2000
Hospital-Based Health Care Systems: The Post-BBA Era
Site Visit
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April 10–11, 2000
Site Visit to Seattle — University of Washington Academic Medical Center
Forum Session
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March 31, 2000
Designing a Medicare Prescription Drug Benefit: Safety and Structure Considerations
Site Visit
—
March 20, 2000
Site Visit to Detroit — Henry Ford Health System
Site Visit
—
March 16–17, 2000
Site Visit to Richmond and Hampton Roads — Bon Secours Health System, Inc.
Issue Brief
No. 750
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November 8, 1999
Medicare Competitive Pricing: Lessons Being Learned in Phoenix and Kansas City
Forum Session
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November 8, 1999
Medicare Competitive Pricing: Lessons Being Learned in Phoenix and Kansas City
Issue Brief
No. 749
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October 27, 1999
The ABCs of PBMs
Forum Session
—
October 27, 1999
The ABCs of PBMs
Issue Brief
No. 744
—
July 13, 1999
Access to Home Health Services under Medicare's Interim Payment System
Forum Session
—
July 13, 1999
Access to Home Health Services under Medicare's Interim Payment System
Issue Brief
No. 743
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July 7, 1999
Implementing the BBA: The Challenge of Moving Medicare Post-Acute Services to PPS
Forum Session
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July 7, 1999
Implementing the BBA: The Challenge of Moving Medicare Post-Acute Services to PPS
Issue Brief
No. 742
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June 25, 1999
Canada's Generalist Training: Are There Lessons for the United States?
Forum Session
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June 25, 1999
Canada's Generalist Training: Are There Lessons for the United States?
Forum Session
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April 8, 1999
Providing Outpatient Prescription Drugs through Medicare: Can We Afford To? Can We Afford Not To?
Issue Brief
No. 734
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March 30, 1999
Margins As Measures: Gauging Hospitals' Financial Health
Forum Session
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March 30, 1999
Margins As Measures: Gauging Hospitals' Financial Health
Issue Brief
No. 733
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March 24, 1999
Examining the Links between Retirement and Health Insurance: Implications for Medicare Eligibility
Forum Session
—
March 24, 1999
Examining the Links between Retirement and Health Insurance: Implications for Medicare Eligibility
Background Paper
—
March 1999
Providing Outpatient Prescription Drugs through Medicare: Can We Afford To? Can We Afford Not To?
Issue Brief
No. 730
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February 5, 1999
Medicare HMO Pullouts: What Do They Portend for the Future of Medicare+Choice?
Forum Session
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February 5, 1999
Medicare HMO Pullouts: What Do They Portend for the Future of Medicare+Choice?
Issue Brief
No. 729
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January 25, 1999
Filling the Geriatric Gap: Is the Health System Prepared for an Aging Population?
Forum Session
—
January 25, 1999
Filling the Geriatric Gap: Is the Health System Prepared for an Aging Population?
Site Visit
—
November 17–20, 1998
Site Visit to Southern California — Plans and Providers: Risk, Accountability, and Staying Power
Issue Brief
No. 723
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July 24, 1998
Communicating to Beneficiaries about Medicare+Choice: Opportunities and Pitfalls
Forum Session
—
July 24, 1998
Communicating to Beneficiaries about Medicare+Choice: Opportunities and Pitfalls
Issue Brief
No. 722
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July 9, 1998
Medicare Coverage and Technology Diffusion: Past, Present, and Future
Forum Session
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July 9, 1998
Medicare Coverage and Technology Diffusion: Past, Present, and Future
Issue Brief
No. 648
—
May 6, 1994
Federal Support of Medical Education: Framing the Issues for the Systems Reform Debate