Primary tabs

Department of Health and Human Services Seal

The United States Department of Health and Human Services (HHS), also known as the Health Department, is a cabinet-level department of the U.S. federal government with the goal of protecting the health of all Americans and providing essential human services. The official HHS motto is "Improving the health, safety, and well-being of America."

Other Access

The information on this page (the dataset metadata) is also available in these formats.

JSON RDF

via the DKAN API

Impact of Continued Biased Disenrollment from the Medic...

Impact of Continued Biased Disenrollment from the Medicare Advantage Program to Fee-for-Service
As reported in Impact of Continued Biased Disenrollment from the Medicare Advantage Program to Fee-for-Service, published in Volume 2, Issue 4, of the Medicare and Medicaid Research Review, disenrollment from the Medicare Advantage (MA) program to fee-for-service (FFS) continues to occur disproportionately among high-cost beneficiaries. Disenrollees incurred 1,021 dollars per month in Medicare payments following disenrollment to FFS in 2007, which was 28 percent higher than predicted based on risk scores used to set MA payment rates. Differences between actual and predicted payments were smaller for disenrollees of Preferred Provider Organizations (PPOs) and Private Fee-for-Service (PFFS) plans than for Health Maintenance Organizations (HMOs), indicating less biased disenrollment from PPOs and PFFS plans. Analysis of 10 individual MA plans revealed considerable variation in the degree of biased disenrollment. These findings raise concerns about care experiences among sicker enrollees and increased costs to Medicare.

Data and Resources

FieldValue
Publisher
Modified
2016-04-05
Bureau Code
009:38 - Centers for Medicare and Medicaid Services
Release Date
2013-08-02
Identifier
37f462f7-85a5-4783-b160-0415185dc6cd
License
Author
Centers for Medicare & Medicaid Services
Public Access Level
Public
Additional Info: 
FieldValue

Subject Area 1

Medicare

author_id

http://healthdata.gov/id/agency/cms

harvest_harvester_version

0.9ap

harvest_last_updated

2014-11-20T16:57:01.108730

source_hash

56df6a4e154dabf40a29a8057a938b39a1abf760

source_identifier

419

source_title

CMS Data Navigator

source_url

http://dnav.cms.gov/Service/DataNavService.svc/json