Medicare risk contract

Medicare risk contract

An HMO-like format for delivering care under Medicare in which a patient/client pays a flat fee to a Medicare risk contractor, who is responsible for delivering healthcare; a person covered under an MRC receives only listed services provided by listed providers.

Medicare risk contract

Managed care An HMO-like format for delivering care under Medicare in which a Pt/client pays a flat fee to a Medicare risk contractor, which is then responsible for delivering health care; a person covered under an MRC receives only listed services provided by listed providers. See Medicare.
References in periodicals archive ?
Although enrollment in such plans is small, it is growing and appears to be affecting the composition of the Medicare risk contract population.
Recent Determinants of New Entry of HMOs into a Medicare Risk Contract.
The PHO is beginning its second year of a Medicare risk contract with the Fallon Community Health Plan, she explained at a meeting on Medicaid and Medicare sponsored by the National Managed Health Care Congress.
In 1995, a 300-bed community hospital in an affluent suburb north of Chicago, entered into its first Medicare risk contract.
In this role she successfully brought the Medicare Risk Contract into the company, a process which required a successful yearlong negotiation with the federal office of Health Financing.
Firms are positively influenced by the payment assigned to counties (Adamache and Rossiter 1986; Porell and Tompkins 1993; Porell and Wallack 1990; Serrato, Brown, and Bergeron 1995); characteristics of the Medicare population in the area such as income status, proportion disabled, and size of the elderly population (Adamache and Rossiter 1986; Porell and Tompkins 1993; Porell and Wallack 1990; Serrato, Brown, and Bergeron 1995); the size of commercial risk plan enrollment (Welch 1996); the firm's financial performance (Serrato, Brown, and Bergeron 1995); and whether the Medicare risk contract is a regional component of the firm's products (Porell and Tompkins 1993).
The surveyed HMOs include 15 HMOs currently serving rural Medicare risk enrollees, 1 HMO that recently dropped its Medicare risk contract to serve rural enrollees, and 11 HMOs that have commercial enrollees in 5 or more rural counties, but no rural Medicare risk enrollees.
The HMO, to be victorious, must achieve maximum cost savings under its Medicare Risk Contract.
What about the elderly patients from the growing Medicare Risk Contract population who required more time commitment per visit?
The senior plan is a Medicare risk contract initiated as one of the first federal demonstration projects.
5, 1998--Health Net, the third largest provider of managed Medicare benefits in California, has notified the Health Care Financing Administration (HCFA) that it will not renew its Medicare risk contract in Tulare County and Kings County effective Jan.
In contrast exclusively rural HMOs, including the one rural HMO that has a Medicare risk contract, exhibited a strong service commitment to the rural counties in their service areas.

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