Nationwide Analysis of New Entrants into Medicare+Choice Demonstrations

Research center:
Lead researcher:
Project funded:
September 2003
Project completed:
April 2007
Topic:

This project will examine the effects of recent changes in the Medicare+Choice (M+C) program on enrollment in rural areas and on activities of rural-based health plans. Recognizing that closed-panel and staff-model health maintenance organizations are not practical in much of rural America, and that provider sponsored organizations by and large have not been attractive to provider networks, the Centers for Medicare & Medicaid Services created a demonstration program to test the assumption that preferred provider organizations could gain a foothold in many regions of the country. The 33 new Medicare plans in 23 states were announced in August 2002, and enrollment to began in January 2003.

This project is designed to explore the decisions of health plans to enter markets and beneficiaries to enroll in plans. Researchers working on this project will continue an earlier RUPRI Center project that reported rural enrollment in M+C plans and will replicate an earlier design of case studies to explore the reasons plans are active in rural areas and why they may or may not be successful.

A policy paper will be produced.


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