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Contents
SUMMARY
Recommendation 1, 9
Recommendation 2, 11
Recommendation 3, 13
Recommendation 4, 19
Recommendation 5, 20
Recommendation 6, 22
Recommendation 7, 24
Appendix: Additional Commentary Regarding Choice
Facilitating Organizations, 27
The contents of the entire report,
from which this Summary is extracted,
are listed below.
1 OVERVIEW
The Medicare Program, 11
Medicare Managed Care, 13
Restructuring Medicare and the Context
for the TOM Study, 21
How is the Medicare Market Different?, 23
The Committee's Charge, 28
Definitions and Study Approach, 29
. . .
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1
11
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xzv
CONTENTS
SYMPOSIUM SUMMARY
Structuring Accountability for Medicare:
Looking at a Continuum of Options, 39
Structuring Choice: A Look at Mode] Programs, 46
Are Medicare Beneficiaries Different?, 50
What Information Do Medicare Beneficiaries
Want and Need?, 56
How Do You Get the Information Out Effectively?, 63
Enrollee Satisfaction and Consumer Protections, 65
Proposed Legislative Changes to the Medicare Risk Program:
A "Report Card," 75
39
FINDINGS AND RECOMMENDATIONS
REFERENCES
REFERENCES CONSULTED
APPENDIXES
A Additional Commentary Regarding Choice
Facilitating Organizations
B Invitational Symposium Agenda
C Symposium Participants
D Commissioned Papers
E The Structure and Accountability for Medicare
Health Plans: Government, the Market, and
Professionalism
F Best Practices for Structuring and Facilitating
Consumer Choice of Health Plans
G Medicare Managed Care: Issues for Vulnerable
Populations
H Reaching and Educating Beneficiaries About Choice
I What Information Do Consumers Want and Need:
What Do We Know About How They Judge Quality
and Accountability?
Medicare Managed Care: Protecting Consumers
and Enhancing Satisfaction
K Medicare Managed Care: Current Requirements
and Practices to Ensure Accountability
80
111
116
123
125
131
136
137
159
195
236
270
290
326
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CONTENTS
What Should Be the Basic Ground Rules for
Plans Being Able to Participate in the Medicare
Managed Care Market? Case Study: The
California Public Employees' Retirement System
INDEX
xv
338
353
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