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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 . . . xzzz 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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