The purpose of this project is for the Institute of Medicine to organize and convene a two-day invitational symposium on consumer protection and accountability in Medicare managed care. The symposium will elevate the visibility and importance of these issues and provide balanced analysis of current policies and practices. Recommendations will be made for steps that the public and private sectors can take to help ensure that the elderly are well served by the anticipated growth in Medicare managed care. An expert committee will be selected to help IOM staff prepare the agenda and identify symposium participants and authors for background papers. The intended audience includes government agency and congressional staff and industry and consumer group representatives. The background papers may address the following topics: (1) current provisions in the Medicare program that promote public accountability and informed purchasing in managed care; (2) experience to date in Medicare managed care about the efficacy of existing accountability and protection provisions; (3) the impact of options to restructure Medicare on informed consumer purchasing and accountability; (4) lessons learned from accountability and consumer protection provisions that govern managed care for Medicaid and privately insured populations; (5) the special needs of the elderly that should be considered in developing appropriate models for accountable Medicare managed care; and (6) case studies of effective ways that a diverse elderly population can be informed about choosing a health plan and effectively utilizing its services. A consensus statement will be prepared describing the major public policy issues, best practices, and areas for further research highlighted in the symposium papers and discussion. This statement will be incorporated into a larger symposium summary which will include the final versions of commissioned papers and a brief overview of the event itself. The report will be published through the National Academy Press. Finally, the proposed project parallels a Foundation-supported analysis by the Center for Health Care Rights (I.D. 20179) of state consumer protection laws for the privately insured enrolled in managed care. The findings will be released in July 1995.
Amount Awarded $230,750.00
Awarded on: 6/28/1995
Time frame: 7/1/1995 - 9/30/1997
Grant Number: 27343