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ExpectMore.govExpectMore.gov home pageEXPECT FEDERAL PROGRAMS TO PERFORM WELL, AND BETTER EVERY YEAR.
 
Program Assessment

Program

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Medicare

Medicare finances health insurance for eligible elderly and disabled individuals. As of January 1, 2006, the Medicare benefit includes outpatient prescription drug coverage.

Rating

What This Rating Means

PERFORMING
Moderately Effective

In general, a program rated Moderately Effective has set ambitious goals and is well-managed. Moderately Effective programs likely need to improve their efficiency or address other problems in the programs' design or management in order to achieve better results.
  • Medicare has been successful in protecting the health of beneficiaries and is working to strengthen its management practices. In 2004, 72.8% of beneficiaries age 65 or older received flu vaccinations, an increase over 70.4% from the prior year. The program continues to improve how it accounts for payments. In 2005, improper Medicare payments were reduced from $21.7 billion to $12.1 billion.
  • In December 2003, the President signed the Medicare Modernization Act. The MMA created a new outpatient prescription drug benefit in Medicare, which became available on January 1, 2006. Successful implementation of the benefit has been a priority and data indicate that beneficiaries are satisfied with the new benefit and cost has decreased by 20 percent since summer 2005.
  • In its effort to improve linkages between Medicare payment and provider performance, as recommended in the Medicare assessment, the Centers for Medicare and Medicaid Services is conducting a number of demonstration projects, including the Premier Hospital Quality Demonstration and the Physician Gainsharing Demonstration.

Improvement Plan

About Improvement Plans

We are taking the following actions to improve the performance of the program:

  • Reducing the Medicare payment error rate and strengthening program integrity initiatives.
  • Continuing timely implementation of the Medicare Prescription Drug, Improvment, and Modernization Act of 2003.
  • Linking Medicare payment to provider performance.

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