The U.S. Medicare programme provides health insurance coverage to adults over 65 years and the permanently disabled. Traditional Medicare is a public insurance programme; the government reimburses private providers directly. However, Medicare beneficiaries may choose instead to receive their benefits through a private health insurance plan (referred to as Medicare Advantage (MA)). The MA programme has grown substantially over time: private health insurance plans now cover over 17 million Medicare beneficiaries and cost the U.S. government over $190 billion (£144 billion) annually.

The aim of this project is to examine the role of the private health insurance sector within the public Medicare programme. This research has two related arms:

• One arm of this research is aimed at examining payment policy and its impact on private health insurance plan participation in the MA programme.
• A second arm of this research examines the relationship between insurer market structure and the cost and quality of health insurance coverage in the MA programme.

Funding

Early phases of this work were supported via a grant from the Jayne Koskinas Ted Giovanis Foundation for Health and Policy.

Contact:

Dr Emily Adrion, PhD, MSc - Emily.Adrion@ed.ac.uk