Medicare News
| For Immediate Release: | Contact: |
| Friday, February 28, 1997 | CMS Office of Public Affairs 202-690-6145 |
For questions about Medicare please call 1-800-MEDICARE or visit www.medicare.gov. |
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HCFA EXPANDS MEDICARE CHOICES DEMONSTRATION
Options for Medicare beneficiaries are being expanded once again. The Health Care Financing Administration announced today that three more plans are now beginning to enroll seniors in the Medicare Choices demonstration project.
The Medicare Choices demonstration project lets Medicare beneficiaries try other types of managed care plans besides traditional HMOs, such as provider sponsored networks (PSNs) and preferred provider organizations (PPOs). Enrollment in the project's first participating plans began Jan. 1, 1997. Enrollment in the three new plans can begin March 1, 1997.
"The Clinton administration is committed to giving seniors quality and choice in Medicare. Continued expansion of this demonstration project does just that," said Health and Human Services Secretary Donna E. Shalala.
The three new plans are:
- Yellowstone Community Health Plan, a nonprofit, provider-sponsored HMO serving four primarily rural counties around Billings, Mont. It is owned by St. Vincent Hospital and Health Center in Billings, an affiliate of the Sisters of Charity in Leavenworth, Kan., and is governed by a board of community representatives. The plan will offer a basic benefits package with reduced copayments and expanded benefits. It will serve predominately rural areas and may expand to additional rural counties.
- The Mount Carmel Health System, a nonprofit provider sponsored network (PSN) of physicians and three hospitals in Columbus, Ohio. It is owned by the Holy Cross Health System Corporation and the Sisters of Saint Francis of Holy Name Province. It will offer Medicare beneficiaries in Franklin County and adjacent zip codes a choice of a basic plan with reduced copayments and expanded benefits or, for an additional monthly premium, a point-of-service plan allowing members to seek services outside Mt. Carmel's network.
- The Ohio Health Alliance, a joint venture of The Ohio State University Health Care System and the U.S. Health Corporation HMO. It will offer both a basic plan with reduced copayments and no premium, and, for a monthly premium, a high option plan with expanded benefits. The Ohio Health Alliance program will initially be offered in Franklin and four other counties around Columbus. Payment will be prospectively adjusted for beneficiaries' health status.
"We are very excited to see this project grow," said HCFA Administrator Bruce C. Vladeck. "The addition of the Billings, Montana, site in particular shows how the Choices demonstration project is getting managed care to rural areas where our beneficiaries have had the fewest options."
The Choices project now has a total of eight participating plans. Other areas with participants include Orlando, Fla., Houston, Texas, and Philadelphia, Pa. HCFA is working with 10 other candidate plans and expects to add more plans to the demonstration this year.
Five million of Medicare's 38 million beneficiaries have joined more than 350 managed care plans, with another 80,000 joining each month.
