Reports Examine MA Plan Payment System, Health Care Quality, Disparities; JAMA Commentary Discusses 'Shared Responsibility'

Main Category: Public Health
Also Included In: Health Insurance / Medical Insurance;  Medicare / Medicaid / SCHIP
Article Date: 06 Mar 2008 - 9:00 PDT

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"From Politics to Policy: A New Payment Approach in Medicare Advantage," Health Affairs: In the Web exclusive, Robert Berenson, a senior fellow at the Urban Institute who headed health plan contracting at CMS from 1998 to 2000, proposes a new method of setting benchmarks against which MA plans bid. Berenson advocates benchmarks consistent with evidence that MA plan costs vary less geographically than fee-for-service Medicare expenses and also would eliminate payment floors for rural areas. His approach would pay plans in these "floor counties" less than under current law but more than under a local-neutrality proposal by the Medicare Payment Advisory Committee (Berenson, Health Affairs, 3/4).

New reports, Agency for Healthcare Research and Quality: AHRQ recently released two new reports -- the 2007 National Healthcare Quality Report and the 2007 National Healthcare Disparities Report. The reports examine improvements in health care quality between 1994 and 2005 and trends in health care disparities since 1994 (AHRQ release, 3/4).

"Who Really Pays for Health Care? The Myth of 'Shared Responsibility,'" Journal of the American Medical Association: In the commentary, Ezekiel Emanuel of the department of bioethics at NIH and Victor Fuchs of the department of economics at Stanford University discuss the "misconception" that employers and the government pay a significant share of U.S. health care costs. According to Emanuel and Fuchs, employer-sponsored health benefits are a component of overall worker compensation, and the government increases taxes on the current population, borrows from future generations or cuts other necessary programs to pay for increases in health care costs. Emanuel and Fuchs also discuss how the "myth of shared responsibility" makes it difficult to remove employers as part of efforts to overhaul the U.S. health care system (Emanuel/Fuchs, JAMA, 3/5).

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