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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 is successful in protecting the health of beneficiaries and is strengthening its management practices. CMS reduced post surgical infections by increasing use of preventative antibiotics prior to surgery. CMS has also reduced improper payments by $10.9 billion over the last 3 years.
  • 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 currently 90 percent of beneficiaries have prescription drug coverage from Part D or other sources.
  • In its effort to improve linkages between Medicare payment and provider performance, the Centers for Medicare & Medicaid Services is conducting a number of demonstration projects, including the Premier Hospital Quality Demonstration and the Physician Group Demonstration.

Improvement Plan

About Improvement Plans

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

  • Continue greater emphasis on sound program and financial management including efforts to improve program integrity.
  • Continuing timely implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
  • Linking Medicare payment to provider performance.

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