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A Competitive Bidding Approach to Medicare Reform

April 1, 2013

Medicare reform is a critical issue for the public agenda. The most promising option for addressing Medicare reform is competitive bidding -- using health plans' bids to determine the government's contribution to a basic set of benefits in every market area. This paper begins with a review of the history of competitive bidding in Medicare. It then moves to a definition of terms, which is crucial in any discussion of competitive pricing because the often-heated public debate around these issues frequently distorts positions and confuses issues by conflating different terms and making some arguments appear other than they are. Following this terminological exercise, the report includes a series of sections discussing competitive bidding in Medicare, with special focus on the challenges to introducing it.

Designing a Mixed Public and Private System for the Health Insurance Market

August 31, 2008

Reviews features of a reform proposal offering both public and private plans in a government-run purchasing pool, modeled on Medicare, in the commercial insurance market. Analyzes potential issues, including standardization of benefits and risk selection.