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Community-Based Assessments


Under the Medicare+Choice program, firms have been able to offer products on a county by county basis, making participation decisions based on factors such as county payment rate, strength of local provider networks, and beneficiary's affinity for managed care. In 2003, Medicare+Choice payment rates paid to plans range from $495 in rural floor counties to a high of $872 in Staten Island, NY. Consequently, there is large national variation in benefits, premiums, and plan participation. A recent site visit to Palm Beach county and neighboring Miami-Dade highlighted many of the differences between counties which may pose challenges to firms trying to enter large service areas.

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