Evaluating alternative risk adjusters for Medicare.

Part of a special section on dually eligible Medicare and Medicaid beneficiaries. The writers use three years of Medicare Current Beneficiary Survey to assess alternative demographic, survey, and claims-based risk adjusters for Medicare capitation payment. They contend that the survey health-statu...

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Publicado en:Health Care Financing Review Vol. 20; no. 2; pp. 109 - 130
Autores principales: Pope, Gregory C., Adamache, Killard W., Walsh, Edith G.
Formato: Artículo
Publicado: HCFA ORDS Publications Winter 1998
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Acceso en línea:Ver este registro en EBSCOhost
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          Pope, Gregory C.
          Adamache, Killard W.
          Walsh, Edith G.
      su:
        Medicare
        Medical care
        Risk assessment
        Medical care financing
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        subj:
          Medicare
          Medical care
          Risk assessment
          Medical care financing
      keyword: Risk adjustment (Medical care)
      ab: Part of a special section on dually eligible Medicare and Medicaid beneficiaries. The writers use three years of Medicare Current Beneficiary Survey to assess alternative demographic, survey, and claims-based risk adjusters for Medicare capitation payment. They contend that the survey health-status models have three to four times the predictive power of the demographic models. In addition, the assert that the risk-adjustment model derived from claims diagnoses has 75-percent greater predictive power than a comprehensive survey model. Furthermore, they argue that no single model predicts average expenditures well for all beneficiaries subgroups of interest, implying that a combined model may be appropriate. They conclude that more data are required to obtain stable estimates of model parameters and consider the advantages and disadvantages of alternative risk adjusters.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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