Modeling decisions of Medicare health plans and determining if regional competitive bidding will work

The Foundation's Changes in Health Care Financing and Organization program was designed to support research, demonstration, and evaluation projects examining major changes in health care financing.This project will model the market entry and exit behavior of health plans (HMOs and PPOs) to provide input to policy makers trying to enhance private plan participation in Medicare. The study will determine whether plans will require higher premiums or more extensive risk sharing to induce them to enter counties or regions with low-population densities. The project will also model the enrollment and disenrollment from health plans to determine whether differences in the service area definitions (county versus regional service areas) may exacerbate adverse selection and cause instability in plan premiums and participation. The purpose of this project is to help provide information to federal policy makers implementing Medicare advantage and planning for private plan competition demonstrations.

Grant Details

Amount Awarded $356,373.00

Awarded on: 6/10/2004

Time frame: 7/1/2004 - 12/31/2006

Grant Number: 51151


Boston University School of Public Health

Talbot Building
715 Albany Street
Boston, 02118-2526


Steven D. Pizer
Project Director