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dc.contributor.authorEllis, Randall P.en_US
dc.contributor.authorPope, Gregory C.en_US
dc.contributor.authorIezzoni, Lisa I.en_US
dc.contributor.authorAyanian, John Z.en_US
dc.contributor.authorBates, David W.en_US
dc.contributor.authorBurstin, Helenen_US
dc.contributor.authorAsh, Arlene S.en_US
dc.coverage.spatialUnited Statesen_US
dc.date.accessioned2018-02-07T18:48:21Z
dc.date.available2018-02-07T18:48:21Z
dc.date.issued1996
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/10172666
dc.identifier.citationRP Ellis, GC Pope, L Iezzoni, JZ Ayanian, DW Bates, H Burstin, AS Ash. 1996. "Diagnosis-based risk adjustment for Medicare capitation payments.." Health Care Financ Rev, Volume 17, Issue 3, pp. 101 - 128.
dc.identifier.issn0195-8631
dc.identifier.urihttps://hdl.handle.net/2144/26892
dc.description.abstractUsing 1991-92 data for a 5-percent Medicare sample, we develop, estimate, and evaluate risk-adjustment models that utilize diagnostic information from both inpatient and ambulatory claims to adjust payments for aged and disabled Medicare enrollees. Hierarchical coexisting conditions (HCC) models achieve greater explanatory power than diagnostic cost group (DCG) models by taking account of multiple coexisting medical conditions. Prospective models predict average costs of individuals with chronic conditions nearly as well as concurrent models. All models predict medical costs far more accurately than the current health maintenance organization (HMO) payment formula.en_US
dc.format.extent101 - 128en_US
dc.languageeng
dc.relation.ispartofHealth Care Financ Rev
dc.rightsThis article is in the public domain and may be reproduced or copied without permission; however, citation to source is appreciated.en_US
dc.subjectScience & technologyen_US
dc.subjectLife sciences & biomedicineen_US
dc.subjectHealth care sciences & servicesen_US
dc.subjectHealth policy & servicesen_US
dc.subjectHospitalizationen_US
dc.subjectCapitation feeen_US
dc.subjectDiagnosis-related groupsen_US
dc.subjectDisability evaluationen_US
dc.subjectDisabled personsen_US
dc.subjectFemaleen_US
dc.subjectHealth care costsen_US
dc.subjectHealth maintenance organizationsen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMedicaiden_US
dc.subjectMedicareen_US
dc.subjectModels, economicen_US
dc.subjectRate setting and reviewen_US
dc.subjectRegression analysisen_US
dc.subjectRisk managementen_US
dc.subjectUnited Statesen_US
dc.subjectHumansen_US
dc.titleDiagnosis-based risk adjustment for Medicare capitation payments.en_US
dc.typeArticleen_US
pubs.elements-sourcepubmeden_US
pubs.notesEmbargo: Not knownen_US
pubs.organisational-groupBoston Universityen_US
pubs.organisational-groupBoston University, College of Arts & Sciencesen_US
pubs.organisational-groupBoston University, College of Arts & Sciences, Department of Economicsen_US
pubs.publication-statusPublisheden_US


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