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PFFS plans are indemnity plans (like TM) that were prohibited from having restrictive provider networks and from actively managing care.
Disenrollees from PPOs and PFFS plans incurred lower payments post-disenrollment than disenrollees from HMOs and similar types of plans, and their average payments were closer to predicted levels.
MIPPA supporters say the changes will improve the quality of the plans; critics say the changes make offering PFFS plans too difficult and expensive, especially in rural communities.
In the MMA, Congress created conditions favorable for rapid growth of MA plans in general and PFFS plans in particular.
While it makes substantial changes to the PFFS alternative within Medicare Advantage, it retains the right of older Americans to add their own money so as to get insurance less likely to ration lifesaving treatment.
The PFFS window of opportunity first opened when Congress created Medicare+Choice in the 1997 Balanced Budget Act.
Fifth, much of the growth in MA enrollment came from PFFS plans.
We also find that CCP market concentration decreases the entry probability of the other two plan types, PFFS plans and PDPs, which is consistent with joint decision making across products within firms, possibly due to economies of scope.
PFFS plans have become widespread only in the last year or so, and some doctors' offices may confuse them with other private Medicare plans (the managed care plans that pay lower rates and that have contracts with only some providers).
PFFS plans are also an important part of the MA landscape, and insurer offerings of these plans were also likely affected by the ACA payment rules.
Most carriers have already stopped offering private fee-for-service plans, and CMS has created a high bar for carriers pursuing network-based PFFS plans.
In addition, the administrative expense ratio deteriorated, following over a 50% reduction in direct premiums written over the last four years as Sterling phases out of the PFFS product.
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