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Int J Health Care Finance Econ. 2009 Mar;9(1):59-81. doi: 10.1007/s10754-008-9047-x. Epub 2008 Sep 27.

Nothing for something? Estimating cost and value for beneficiaries from recent medicare spending increases on HMO payments and drug benefits.

Author information

1
Department of Veterans' Affairs, Health Care Financing & Economics, VA Boston Health Care System, Boston, MA 02130, USA. pizer@bu.edu

Abstract

The Medicare Modernization Act of 2003 added a new outpatient prescription drug benefit to Medicare and increased payments to HMOs. We estimate a nested logit model of plan choice to quantify the welfare benefits from these two expansion paths. We find that the addition of stand-alone prescription drug plans was welfare improving and produced nine times as much value per government dollar as the increase in payments to HMOs. In light of these results, we suggest that HMO bidding procedures should be modified to reduce payments to HMOs by about $67 billion over the next 10 years.

PMID:
18821013
DOI:
10.1007/s10754-008-9047-x
[Indexed for MEDLINE]

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