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P D Fox

Publications and source records attributed to P D Fox.

51 records · Page 3Linked to original sources
PubMedDate not supplied

Applying managed care techniques in traditional Medicare.

Medicare has lagged behind the private sector in its reliance on managed care, which, properly done, has the potential to restrain budget growth and enhance quality. This paper addresses how the Medicare fee-for-service program--traditional Medicare--might apply managed care techniques. It first discusses the institutional constraints Medicare faces in implementing managed care techniques and then presents options for applying these techniques. I propose elements of an overall strategy to incorporate managed care in the fee-for-service program.

Fee-for-Service Plans↗
PubMedDate not supplied

Should Medicare HMO benefits be standardized?

Legislation enacted in 1990 standardized Medigap benefits but not the benefits of health maintenance organizations (HMOs) that serve Medicare beneficiaries. An examination of marketing materials in two large counties reveals the potential for enormous confusion among beneficiaries because of differences in wording to describe the same benefit, health plans' failure to list Medicare-covered services, and the differences in the benefits themselves. To date, the Health Care Financing Administration (HCFA) has not been able to overcome this confusion through the comparative material distributed on its Web site; indeed, significant errors were found, reflecting to some extent the underlying difficulties in characterizing benefits. Ways of ameliorating the situation are discussed.

Health Maintenance Organizations↗