Much of the US health system allows consumers to select among various competing plans. This approach is used in some employer-based health insurance arrangements, in some state Medicaid programs, and in Medicare. In addition, the insurance exchanges that will begin operation in 2014 under the Affordable Care Act will be based on a similar marketplace arrangement. In Medicare, most beneficiaries have the option of enrolling in the Medicare Advantage program, which offers them a choice among multiple private health plans that contract with the government to furnish enrollees with their Medicare benefits. Beneficiaries who elect the traditional fee-for-service Medicare program must also select from competing drug plans if they wish to participate in the Part D drug benefit.
Hoadley J. Performance Ratings and Plan Selection by Medicare Beneficiaries. JAMA. 2013;309(3):287–288. doi:10.1001/jama.2012.217002
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