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Extending Medicare Coverage for Preventive and Other Services

Extending Medicare Coverage for Preventive and Other Services PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309183502
Category : Medical
Languages : en
Pages : 410

Book Description
This report, which was developed by an expert committee of the Institute of Medicine, reviews the first three services listed above. It is intended to assist policymakers by providing syntheses of the best evidence available about the effectiveness of these services and by estimating the cost to Medicare of covering them. For each service or condition examined, the committee commissioned a review of the scientific literature that was presented and discussed at a public workshop. As requested by Congress, this report includes explicit estimates only of costs to Medicare, not costs to beneficiaries, their families, or others. It also does not include cost-effectiveness analyses. That is, the extent of the benefits relative to the costs to Medicareâ€"or to society generallyâ€"is not evaluated for the services examined. The method for estimating Medicare costs follows the generic estimation practices of the Congressional Budget Office (CBO). The objective was to provide Congress with estimates that were based on familiar procedures and could be compared readily with earlier and later CBO estimates. For each condition or service, the estimates are intended to suggest the order of magnitude of the costs to Medicare of extending coverage, but the estimates could be considerably higher or lower than what Medicare might actually spend were coverage policies changed. The estimates cover the five-year period 2000-2004. In addition to the conclusions about specific coverage issues, the report examines some broader concerns about the processes for making coverage decisions and about the research and organizational infrastructure for these decisions. It also briefly examines the limits of coverage as a means of improving health services and outcomes and the limits of evidence as a means of resolving policy and ethical questions.

Extending Medicare Coverage for Preventive and Other Services

Extending Medicare Coverage for Preventive and Other Services PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309183502
Category : Medical
Languages : en
Pages : 410

Book Description
This report, which was developed by an expert committee of the Institute of Medicine, reviews the first three services listed above. It is intended to assist policymakers by providing syntheses of the best evidence available about the effectiveness of these services and by estimating the cost to Medicare of covering them. For each service or condition examined, the committee commissioned a review of the scientific literature that was presented and discussed at a public workshop. As requested by Congress, this report includes explicit estimates only of costs to Medicare, not costs to beneficiaries, their families, or others. It also does not include cost-effectiveness analyses. That is, the extent of the benefits relative to the costs to Medicareâ€"or to society generallyâ€"is not evaluated for the services examined. The method for estimating Medicare costs follows the generic estimation practices of the Congressional Budget Office (CBO). The objective was to provide Congress with estimates that were based on familiar procedures and could be compared readily with earlier and later CBO estimates. For each condition or service, the estimates are intended to suggest the order of magnitude of the costs to Medicare of extending coverage, but the estimates could be considerably higher or lower than what Medicare might actually spend were coverage policies changed. The estimates cover the five-year period 2000-2004. In addition to the conclusions about specific coverage issues, the report examines some broader concerns about the processes for making coverage decisions and about the research and organizational infrastructure for these decisions. It also briefly examines the limits of coverage as a means of improving health services and outcomes and the limits of evidence as a means of resolving policy and ethical questions.

Assessing Health Care Reform

Assessing Health Care Reform PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309049261
Category : Medical
Languages : en
Pages : 85

Book Description
This book establishes a framework for assessing health care reform proposals and their implementation. It helps clarify objectives, identifies issues to be addressed in proposals, distinguishes between short- and long-term expectations and achievements, and directs attention to important but sometimes neglected questions about the organization and provision of health care services. In addition, the volume presents a discussion and analysis of issues essential to achieving fundamental goals of health care reform: to maintain and improve health and well-being, to make basic health coverage universal, and to encourage the efficient use of limited resources. The book is a useful resource for anyone developing or assessing options for reform.

The Medicare Handbook

The Medicare Handbook PDF Author:
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 60

Book Description


Extending Medicare Reimbursement in Clinical Trials

Extending Medicare Reimbursement in Clinical Trials PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309068886
Category : Medical
Languages : en
Pages : 86

Book Description
Increasingly over the past five years, uncertainty about reimbursement for routine patient care has been suspected as contributing to problems enrolling people in clinical trials. Clinical trial investigators cannot guarantee that Medicare will pay for the care required, and they must disclose this uncertainty to potential participants during the informed consent process. Since Medicare does not routinely "preauthorize" care (as do many commercial insurers) the uncertainty cannot be dispelled in advance. Thus, patients considering whether to enter trials must assume that they may have to pay bills that Medicare rejects simply because they have enrolled in the trial. This report recommends an explicit policy for reimbursement of routine patient care costs in clinical trials. It further recommends that HCFA provide additional support for selected clinical trials, and that the government support the establishment of a national clinical trials registry. These policies (1) should assure that beneficiaries would not be denied coverage merely because they have volunteered to participate in a clinical trial; and (2) would not impose excessive administrative burdens on HCFA, its fiscal intermediaries and carriers, or investigators, providers, or participants in clinical trials. Explicit rules would have the added benefit of increasing the uniformity of reimbursement decisions made by Medicare fiscal intermediaries and carriers in different parts of the country. Greater uniformity would, in turn, decrease the uncertainty about reimbursement when providers and patients embark on a clinical trial.

Medicare Coverage of Diabetes Supplies & Services

Medicare Coverage of Diabetes Supplies & Services PDF Author:
Publisher:
ISBN:
Category : Diabetes
Languages : en
Pages : 32

Book Description


Care Without Coverage

Care Without Coverage PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309083435
Category : Medical
Languages : en
Pages : 213

Book Description
Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

The Affordable Care Act

The Affordable Care Act PDF Author: Tamara Thompson
Publisher: Greenhaven Publishing LLC
ISBN: 0737776196
Category : Young Adult Nonfiction
Languages : en
Pages : 130

Book Description
The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.

The Future of Disability in America

The Future of Disability in America PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309104726
Category : Medical
Languages : en
Pages : 619

Book Description
The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.

Enrolling in Medicare Part a and Part B

Enrolling in Medicare Part a and Part B PDF Author: U. S. Department Human Services
Publisher: Createspace Independent Publishing Platform
ISBN: 9781492989943
Category :
Languages : en
Pages : 0

Book Description
Medicare is health insurance for: People 65 or older, Under 65 with certain disabilities, Any age with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a kidney transplant). Medicare Part A (Hospital Insurance): Part A helps cover your inpatient care in hospitals. Part A also includes coverage in critical access hospitals and skilled nursing facilities (not custodial or long term care). It also covers hospice care and home health care. You must meet certain conditions to get these benefits. Medicare Part B (Medical Insurance): Part B helps cover medically necessary services like doctors' services, outpatient care, and other medical services that Part A doesn't cover. Part B also covers many preventive services. Part B is a voluntary program. However, you need to have Part B if you want to buy Part A. Also available in Spanish.

An Employee's Guide to Health Benefits Under COBRA

An Employee's Guide to Health Benefits Under COBRA PDF Author:
Publisher:
ISBN:
Category : Employer-sponsored health insurance
Languages : en
Pages : 32

Book Description