UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date

8-3-2001

Document Type

Article

Subjects

Adolescent; Adult; Aged; Capitation Fee; Centers for Medicare and Medicaid Services (U.S.); Child; Child, Preschool; Demography; Diagnosis-Related Groups; Female; Humans; Infant; Infant, Newborn; Male; Medicaid; Medicare Part C; Middle Aged; *Models, Econometric; Risk Adjustment; United States

Disciplines

Biostatistics | Epidemiology | Health Services Research

Abstract

The Balanced Budget Act (BBA) of 1997 required HCFA to implement health-status-based risk adjustment for Medicare capitation payments for managed care plans by January 1, 2000. In support of this mandate, HCFA has been collecting inpatient encounter data from health plans since 1997. These data include diagnoses and other information that can be used to identify chronic medical problems that contribute to higher costs, so that health plans can be paid more when they care for sicker patients. In this article, the authors describe the risk-adjustment model HCFA is implementing in the year 2000, known as the Principal Inpatient Diagnostic Cost Group (PIPDCG) model.

Rights and Permissions

Citation: Health Care Financ Rev. 2000 Spring;21(3):93-118. Link to article on publisher's site

Journal/Book/Conference Title

Health care financing review

PubMed ID

11481770

Related Resources

Link to Article in PubMed

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.