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Medicare for the 21st Century: Table of Contents

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PRESIDENT’S PLAN FOR STRENGTHENING AND MODERNIZING
MEDICARE FOR THE 21st CENTURY


TABLE OF CONTENTS


OVERVIEW


  1. MAKING MEDICARE MORE COMPETITIVE AND EFFICIENT
    1. Private Sector Purchasing & Quality Improvement Tools for Traditional Medicare
      1. Promoting use of high-quality, cost-effective health care providers
      2. Primary care case management and disease management
      3. Information and care coordination for Medicare-Medicaid dual eligibles
      4. Innovative purchasing tools and contracting reform

    2. Competitive Defined Benefit Proposal
      1. Beneficiary premiums based on choice of managed care plans
      2. Government payments based on plan prices
      3. Risk and geographic adjustment

    3. Smoothing Out Balanced Budget Act Policies
      1. Quality assurance fund
      2. Administrative actions to smooth implementation of the BBA
      3. Direct payments to disproportionate share hospitals (DSH)

    4. Constraining Out-Year Medicare Spending Growth
      1. Hospitals
      2. Ambulance, prosthetics and orthotics, and hospice services
      3. Ambulatory surgical centers
      4. Clinical laboratory services, durable medical equipment & parenteral & enteral items

    5. Improving Medicare Management, Including Public/Private Advisory Boards
      1. Increasing accountability through public/private advisory boards
      2. Increasing personnel flexibility


  2. MODERNIZING MEDICARE’S BENEFITS
    1. Prescription Drug Benefit
      1. Benefit design
      2. Financing
      3. Enrollment
      4. Management, payments, and beneficiary protections
      5. Expanded assistance for low-income beneficiaries
      6. Incentives to develop and retain employer-provided retiree drug coverage

    2. Improving Preventive Benefits and Eliminating Cost Sharing
      1. Eliminating all preventive services cost sharing
      2. Information campaign on prevention
      3. U.S. Preventive Services Task Force study of new preventive services for older Americans
      4. Demonstration of smoking cessation drugs and counseling

    3. Rationalizing Cost Sharing and Medigap
      1. New 20 percent coinsurance on clinical laboratory services
      2. Indexing the Part B deductible to inflation
      3. Updating and expanding Medigap plan options
      4. Report to Congress on policy options for supplemental coverage
      5. Access to Medigap

    4. Medicare Buy-In for Certain People Ages 55-56
      1. Medicare buy-in for people ages 62-64
      2. Medicare buy-in for displaced workers ages 55-62
      3. Access to health insurance for retirees whose employers renege on coverage


  3. STRENGTHENING MEDICARE’S FINANCING FOR THE 21st CENTURY
    1. Extending the Life of the Medicare Trust Fund
    2. Responsibly Financing the New Prescription Drug Benefit

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Table of Contents

Section I - Part 1

Section I - Part 2

Section I - Part 3

Section I - Part 4

Section I - Part 5

Section II - Part 1

Section II - Part 2

Section II - Part 3

Section II - Part 4

Section III

Overview

June 29, 1999

June 30, 1999