{
  "id": "RL30702",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "RL30702",
  "active": false,
  "source": "EveryCRSReport.com",
  "versions": [
    {
      "source": "EveryCRSReport.com",
      "id": 102003,
      "date": "2003-06-06",
      "retrieved": "2016-04-08T14:43:35.892544",
      "title": "Medicare+Choice",
      "summary": "Medicare has a long-standing history of offering its beneficiaries an alternative to the traditional\nfee-for-service program. Health Maintenance Organizations and other types of managed care plans\nhave been allowed to participate in the Medicare program, beginning with private health plans\ncontracts in the 1970s and the Medicare risk contract program in the 1980s. Then, in 1997, Congress\npassed the Balanced Budget Act of 1997 (BBA,  P.L. 105-33 ), replacing the risk contract program\nwith the Medicare+Choice (M+C) program. The M+C program established new rules for beneficiary\nand plan participation, along with a new payment methodology. In addition to controlling costs, the\nM+C program was also designed to expand private health plans to markets where access to managed\ncare plans was limited or nonexistent and to offer new types of private health plans. The 106th\nCongress enacted legislation to address some issues arising from the BBA changes. The Balanced\nBudget Refinement Act of 1999 (BBRA,  P.L. 106-113 ) changed the M+C program in an effort make\nit easier for Medicare beneficiaries and plans to participate in the program. Further refinements to\nthe M+C program were included in the Medicare, Medicaid, and SCHIP Benefits Improvement and\nProtection Act of 2000 (BIPA,  P.L. 106-554 ). The 107th Congress made only minor changes to the\nM+C program and was not able to reach consensus on comprehensive modifications. The 108th\nCongress is considering major changes to the program.\n  In 2003, Medicare+Choice plans were available to about 59% of the over 40 million Medicare\nbeneficiaries, and in March 2003 about 12% of them chose to enroll in one of the 146 (including two\nprivate-fee-for service plans) available Medicare+Choice plans. The rapid growth rate of Medicare\nmanaged care enrollment in the 1990s leveled off with the implementation of the M+C program, and\nin fact, there has been a continuous decline in enrollment since 1999 when 17% of beneficiaries were\nenrolled in M+C plans. \n  In order to increase enrollment in Medicare managed care and to allow beneficiaries to better\nmeet their health care needs, the M+C program offers a diverse assortment of managed care plans. \nHowever, achieving the goals of the M+C program has been difficult, in part because the goal to\ncontrol Medicare spending which led to a slowdown in the rate of increase in payments to plans, may\nhave dampened interest by managed care entities in developing new markets, adding plan options,\nand maintaining their current markets.\n  The Congressional Budget Office (CBO) estimates that in 2003 Medicare will spend $35.9\nbillion for all Medicare group plans, (including M+C and other private Medicare arrangements, such\nas demonstrations). By 2013 the projected spending for Medicare group plans will increase to $46.9\nbillion. \n  This report focuses on the recent trends in Medicare managed care, along with an overview of\nthe M+C program. It will be updated as necessary to reflect significant changes made to the M+C\nprogram. For a more detailed analysis of M+C payments, see CRS Report RL30587,\n Medicare+Choice Payments.",
      "type": "CRS Report",
      "typeId": "REPORTS",
      "active": false,
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      "topics": []
    }
  ],
  "topics": [
    "Domestic Social Policy",
    "Economic Policy",
    "Health Policy"
  ]
}