Predicting How Changes in Medicare's Payment Rates Would Affect Risk-Sector Enrollment and Costs.
CONGRESSIONAL BUDGET OFFICE (U S CONGRESS) WASHINGTON DC
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This Congressional Budget Office CBO memorandum describes Medicares risk-based sector, in which health maintenance organizations and other competitive health plans provide services at a set price per enrollee. Specifically, the memorandum estimates how enrollment in Medicares risk-based plans might change in response to changes in Medicares payment policies. The analysis uses predicted changes in enrollment to estimate how different payment rates would affect Medicares costs, both in the risk-based sector and overall. The estimates presented here are valid only under the assumption that all Medicare policies other than payment rates remain the same in both the risk and fee-for-service sectors. If other policies changed as well, the effects of changing Medicares payment rates would differ from those estimated here. In accordance with CBOs mandate to provide objective and impartial analysis, this memorandum makes no recommendations.
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