Includes CCP, PPO Demonstration, Cost, PFFS, Regional PPO and other demonstration contracts. CCP contracts include HMO, PSO, and local PPO contracts. Excludes HCPP and PACE plans.

Mathematica Policy Research, Inc. analysis of CMS MA Enrollment by State County Contract File. Data on the total number of Medicare eligibles from December 2005 were used to calculate plan penetration. For more information including county level data, visit Kaiser's Medicare Health Plan Tracker at http://healthplantracker.kff.org/topicresults.jsp?i=8&rt=2 accessed May 2009.

MA: Medicare Advantage. The Medicare Advantage program was created as part of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003. The Medicare Advantage program replaced the Medicare+Choice program. It gives beneficiaries the option to receive their healthcare through a variety of private health plans (CMS, 2004).
Penetration: is the number of enrollees in Medicare Advantage divided by the number of Medicare beneficiaries.
CCP: Coordinated Care Plans. Refers to Medicare Advantage plans that coordinate care for members (MedPAC, 2004). CCPs include health maintenance organizations (HMOs), provider-sponsored organizations (PSOs) and preferred provider organizations (PPOs) (CMS, 2004) Generally, CCP plan enrollees must use plan providers to get coverage for their care or pay more if they go to providers outside the network. Private plans are allowed to provide additional benefits and to charge beneficiaries an additional premium for them (MedPAC, 2004). As of March 2005, HMOs account for 80 percent of CCP contracts and 98 percent of CCP enrollment.
PPO Demo: Preferred Provider Organization Demonstration Plans. In general, preferred provider organizations use a network to provide the health plans benefits; however; beneficiaries have the option of seeking care outside the network at a higher cost. The Medicare preferred provider organization demonstration began in January 2003. Private health plans that participate in the demonstration have been allowed to share financial risk with the Centers for Medicare and Medicaid Services (CMS) and have been exempted from certain other requirements for CCP plans.
PFFS: Private Fee-For-Service Plans. These plans are private health plans that pay providers directly for the services they provide to Medicare beneficiaries using the same payment rates that apply in the traditional Medicare program (MedPAC, 2004). PFFS plans do not coordinate care, however they are part of the Medicare Advantage program and receive capitated payments from CMS for each enrollee.
Cost: Cost Plans. Cost plans are HMOs that are reimbursed on a cost basis, rather than a capitated amount like other private health plans. Cost enrollees are allowed to receive care outside of their HMO and have those costs be reimbursed through the traditional fee-for-service system.
Other: Other Plans. Refers to all other plans that have been a part of the Medicare+Choice / Medicare Advantage program. There are several plan types that fall into this plan type category including all non-preferred provider organization (PPO) demonstration plans Evercare plans.
Other Demo: Other Demonstration Plans. Refers to all non-preferred provider organization (PPO) demonstration plans and Payment of All-Inclusive Care for the Elderly (PACE) plans.
NA: Not Available.