Medicare Private Plans in the Era of Health Care Reform

Award Amount: $254,710
Approval Date: July 13, 2010
Start Date: July 15, 2010
End Date: January 14, 2012
The George Washington University
44983 Knoll Square 251
Ashburn, Virgina 20147
Principal Investigator: Brian L. Biles, M.D., M.P.H.

The Affordable Care Act contains several provisions designed to make private Medicare Advantage (MA) insurance plans more efficient and more effective in providing Medicare beneficiaries with coordinated care. First, the legislation lowers reimbursement for MA plans so that per-beneficiary costs are more in line with traditional fee-for-service Medicare. It also rewards plans that perform well on measures of quality and patient experience and strengthens protections for beneficiaries in MA plans. This project will analyze the impact that the new policies have on these plans and their enrollees, examine the MA program's potential for developing new models of coordinated care, and offer insight on how private plans might compete in the new health insurance exchanges.