“A Sustainable Future? The Role of Premium Subsidies in Medicare Prescription Drug Plans“
In July 2004, HCFO funded research to provide early and timely information on entry, enrollment, and risk selection of Medicare prescription drug plans and regional PPOs. A research team based at Boston University School of Public Health explored adverse selection in PDPs, the entrance of PPOs into regional markets where health maintenance organizations (HMOs) already exist, and the introduction of PDPs and PPOs in markets where HMOs did not have a presence. Simulation models show that in general, PDPs will be stable, regardless of adverse selection, and that premium support of these programs will ensure viability.
“Regional PPOs in Medicare: What Are The Prospects?: How Do They Contain Rising Costs?”
One of several new types of Medicare health plans that became available for the first time in 2006, regional Medicare preferred provider organizations (PPOs) promised to import the successful commercial PPO model to the Medicare market. Policymakers anticipated that regional PPOs could provide access to comprehensive coverage (including for prescription drugs) at affordable costs to all Medicare beneficiaries. This Findings Brief summarizes recent research and experience related to regional Medicare PPOs and assesses the prospects for this type of health plan in the near future.
