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Improving the Medicare Market: Adding Choice and Protections (1996)
Institute of Medicine (IOM)

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. "Index." Improving the Medicare Market: Adding Choice and Protections. Washington, DC: The National Academies Press, 1996.

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beneficiaries;

Information needs of beneficiaries

age, 198-200

with chronic health problems, 202-203

committee focus, 7

demographics, 23-25, 196

disabled, 196, 198, 202-203

disenrollment, 54-5

diversity, 37, 50-51

dually eligible, 7, 37

elderly, 11

end-stage renal disease, 11

experiences in managed care, 2, 206-215

health outcomes, 208-213

health status, 25-27, 50, 200-202

in HMOs, 4, 51-54, 196, 290

income and poverty status, 203-205

information of interest to, 271, 275-282

knowledge about benefits/Medicare, 27-28, 56, 241-242

minorities, 198

number, by state, 18-19

out-of-pocket expenditures, 206

patient satisfaction, 213-214

qualified, 13, 205

range of options, 80-82, 191

rights, 332

role and responsibility, 33

severely disabled, 7, 11, 37

utilization of services, 203

vulnerable population, 50, 197-198

Benefit plans

comparison charts, 57-58, 73, 78, 89, 97-99, 161, 224, 247-248

design, 161-162, 164-166, 173, 176-177, 192

information wanted by consumers, 58, 59

number and type offered, 161-162, 192

standardization, 47, 49, 69-70, 73, 98, 99, 161, 184, 186, 192, 344 -345

Benova, 255, 256, 260

Best practices.

See also individual case studies

benchmarks, 143, 151, 156-157

concept, 34

HMO, 320-321

in purchasing plans, 151-152

Bethlehem Steel, 250

Blue Cross and Blue Shield, 164, 294

Brook, Robert, 155

C

California

counseling programs, 316

Department of Corporations, 296, 342

disenrollment data, 249

dispute resolution process, 303

emergency care, 308

HMO enrollees, 16, 18, 152, 196

information on benefits, 61, 262

Knox-Keene Health Care Service Plan Act of 1975, 342

marketing abuses, 297

plan purchasing strategies, 152

reform legislation, 171

risk adjustment, 161 n.1

risk-based HMOs, 52

satisfaction with care, 147, 296-298

state oversight of HMOs, 171, 296, 307, 308

California Public Employees' Retirement System (CalPERS), 48-49

accountability measures, 48-49

background, 35-36, 340-342

benefit design, 344-345

cost and performance data, 346-348

customer service, 348-351

number of plans, 48, 150

purchasing role, 153

provider access, 343-344

requirements for participation, 342-348

statutory and regulatory compliance, 342

Capitation payments, 14-15, 21, 45

Cardinal Health, 259

Case management, 52, 221, 222-223

Center for Health Care Rights, 249, 296

Centers for Disease Control and Prevention, 259

Centers of excellence, 156-157

Choice of health plan options.

See also Informed purchasing

benefit plan designs and, 192

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