decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Answer_Book / Managed_Care / What_is_a_Medicare_HMO_the_stats
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Article Overview
This article is a brief overview of Medicare managed care, focusing on CMS-administered HMO arrangements and related beneficiary coverage options. It is intended for readers who need a high-level understanding of how Medicare managed care is organized and how the topic fits within managed care and Medigap-related discussions.
Why This Topic Matters
Understanding the basic structure of Medicare managed care helps readers orient themselves when reviewing coverage, payment, and plan-option questions tied to CMS programs.
What You Will Learn
- The general Medicare managed care options discussed in the article
- How CMS relates to HMO contracting arrangements
- How beneficiary supplemental coverage options are framed in the context of Medicare managed care
- The broad difference between payment approaches described for Medicare HMO arrangements
Who Should Read This
- Medical coders
- Billing staff
- Practice administrators
- Managed care staff
- Healthcare compliance staff
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