Rationale of Reimbursement Systems

Paper Summary:

This paper examines the reimbursement choices for Medicare, centering on cost-based reimbursements. The system most used has changed over the last few years, largely to reduce costs, though costs continue to rise. Many states now use a managed care system for payment, with mixed results. The paper shows that Medicare payments are handled by private insurance companies called intermediaries and carries, and they have contracts with the government.

From the Paper:

"Different methods of reimbursement have been developed for the Medicare system, with different features and different problems. The system most used has changed over the last few years, largely to reduce costs, though costs continue to rise. Medicare is a federal health insurance program. It is intended to provide health insurance for persons 65 and older as well as for certain disabled people. Medicare was created in 1965 as part of Title 18 of the Social Security Act. The system is managed by the Health Care Financing Administration, a federal agency, and by local Social Security Administration offices across the country, which takes applications for Medicare and provides basic eligibility information to applicants."

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