|
||||||||||||||||
|
||||||||||||||||
|
||||||||||||||||
|
| ||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||
Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter.
Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.
Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.
OCR for page 27
RnnnnHiv
Additional Commentary Regarding
Choice Facilitating Organizations
One committee member raised some additional concerns
about the committee's recommendations on Choice Facilitating
Organizations and wanted the following comments to be in-
cluded in this report.
I can see many advantages to organizations that will assist
beneficiaries with making informed choices by evaluating, pre-
screening, and selecting plans that the organization's mem-
bers might choose.
However, I am concerned about a number of potential prob-
lems with these organizations. First these organizations could
segment the Medicare market by including in their member-
ship younger and healthier Medicare beneficiaries and steer-
ing those members to selected plans.
Second, no standards exist for these organizations. What are
they and who will they represent? How will they be funded:
by their membership? by the managed care plans (who will
provide them an enrollment fee for all members signed up
through the organization)? Without some standards for the
types of entities that can become Choice Facilitating Organi-
zations, we could see a new type of fraud perpetrated on Medi-
care beneficiaries.
Third, what standards will these organizations use to select
plans. What is to stop a Choice Facilitating Organization from
selecting the poorest quality plans because they provide the
highest payment for enrollment of members?
27
OCR for page 28
28
IMPROVING THE MEDICARE MARKET
Fourth, these plans may well add a new layer of marketing on
top of the massive marketing of plans to Medicare beneficia-
ries occurring in a number of communities. Medicare benefi-
ciaries may be tempted to join a Choice Facilitating Organiza-
tion because of sophisticated marketing techniques, not
because they have carefully selected plans.
For these reasons, I think extra caution is in order. Perhaps
HCFA could establish a demonstration project to assess the
effectiveness of Choice Facilitating Organizations. At a mini-
mum, some standards should be established for these organi-
zations.
Representative terms from entire chapter:
facilitating organizations
