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The Long-Term Care Partnership Program allows purchasers of private long-term care insurance to qualify eventually for Medicaid coverage of long-term care services without having to meet the same asset requirements as other Medicaid applicants. Partnership programs began in 1987 in four states – New York, California, Connecticut, and Indiana. The 2005 Deficit Reduction Act (DRA) […]

The Census Bureau’s recently released figure on the number of uninsured in 2005 is 46.6 million, an increase of 1.3 million people over 2004. Two new studies by John Holahan and Bowen Garrett of the Urban Institute offer in-depth analyses of the economic and demographic factors that underlie this troubling statistic. Who are the uninsured? […]

A new assessment by The Commonwealth Fund finds that deficiencies in the nation’s health care system cost 100,000 to 150,000 lives and $50 to $100 billion annually. The scorecard compares national averages for the U.S. to national and international benchmarks for 37 indicators. The U.S. received a composite score of 66 out of 100. On […]

Biotechnology accounts for only one percent of insurers’ costs, but those costs are growing at a double digit rate. As science produces increasingly sophisticated and expensive medical products and procedures based on the manipulation of living organisms, payers will increasingly struggle with managing their use. In the private sector today payers are responding to the […]

Some Medicare beneficiaries receive significantly more hospital-based services during the last two years of life than do other beneficiaries. The number of physician visits for Medicare beneficiaries can also vary greatly. What accounts for this variation? Do patients receiving more services tend to get better care, or not? Should policymakers take steps to more closely […]

The Medicare prescription drug program offers coverage for prescription drugs through competing private plans, within a framework established by law and through rules established by the Centers for Medicare and Medicaid Services. In contrast, other countries, including Australia, the UK, and Canada, provide similar prescription drug programs, but within different regulatory structures. How do key […]

One byproduct of the patchwork system of public and private health insurance coverage in the United States is that individuals can gain or lose health insurance as they gain or lose jobs, or gain or lose eligibility for public programs. This phenomenon, known as “churning,” can lead to gaps in health insurance coverage and unnecessary […]

The Medicare Savings Programs provide assistance with premiums — and in some instances, cost sharing requirements — to Medicare beneficiaries of limited income and resources who do not qualify for full Medicaid benefits. Medicare Part B premiums currently amount to over $1,000 annually — which can be a large sum for some beneficiaries. The savings […]

Although it’s best known for introducing the Medicare prescription drug program, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 also made a number of changes to the Medicare managed care program – Medicare Advantage. Among the aims: Keep managed care plans from leaving the program by offering higher payments, and give beneficiaries […]

In today’s health care system it is clear that there needs to be a multidisciplinary approach toward improving quality. Nurses are on the front lines of implementing this quality improvement. By using the highest quality measurements and optimizing the delivery of care, those outside the nursing community would understand the importance of their role in quality performance. As […]

On April 4, the Massachusetts legislature approved a plan that requires all adults to purchase health insurance by July 2007, or face a fine. The plan is projected to expand coverage to 95 percent of the state’s uninsured residents over the next three years. Like many other states, Massachusetts has struggled during the last decade […]