Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model.
This article describes the CMS hierarchical condition categories (HCC) model implemented in 2004 to adjust Medicare capitation payments to private health care plans for the health expenditure risk of their enrollees. We explain the model's principles, elements, organization, calibration, and perform...
| Publicado en: | Health Care Financing Review Vol. 25; no. 4; pp. 119 - 142 |
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| Autores principales: | , , |
| Formato: | Artículo |
| Publicado: |
HCFA ORDS Publications
Summer 2004
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| Sumario: | This article describes the CMS hierarchical condition categories (HCC) model implemented in 2004 to adjust Medicare capitation payments to private health care plans for the health expenditure risk of their enrollees. We explain the model's principles, elements, organization, calibration, and performance. Modifications to reduce plan data reporting burden and adaptations for disabled, institutionalized, newly enrolled, and secondary-payer subpopulations are discussed. Reprinted by permission of the publisher. |
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