Volatility in Medicare AAPCC Rates: 1990-1997

Health Affairs

Volumn 16, Issue 5, 1997, Pages 172-180

  McBride, Timothy D ^a   Penrod, Joan ^b   Mueller, Keith ^b  

^a UNIVERSITY OF MISSOURI ST LOUIS   (United States)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CAPITATION FEE; ECONOMICS; HEALTH CARE COST; HEALTH INSURANCE; HUMAN; MEDICARE; RURAL HEALTH CARE; UNITED STATES; UTILIZATION REVIEW;

CAPITATION FEE; HEALTH CARE COSTS; HUMANS; MANAGED CARE PROGRAMS; MEDICARE; RURAL HEALTH SERVICES; UNITED STATES;

EID: 0006028447     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.16.5.172     Document Type: Review

References (12)

1. B. Dowd, R. Feldman, and J. Christianson, Competitive Pricing for Medicare (Washington: The AEI Press, 1996); and C. Serrato, R.S. Brown, and J. Bergeron, "Why Do So Few HMOs Offer Medicare Risk Plans in Rural Areas?" Health Care Financing Review (Fall 1995): 85-97.
2. B. Dowd, R. Feldman, and J. Christianson, Competitive Pricing for Medicare (Washington: The AEI Press, 1996); and C. Serrato, R.S. Brown, and J. Bergeron, "Why Do So Few HMOs Offer Medicare Risk Plans in Rural Areas?" Health Care Financing Review (Fall 1995): 85-97.
3. F.W. Porell and C.P. Tompkins, "Medicare Risk Contracting: Identifying Factors Associated with Market Exit," Inquiry (Summer 1993): 157-169.
4. S. Palsbo, The AAPCC Explained, Research Brief 8 (Washington: Group Health Association of America, October 1991).
5. R.S. Brown et al., "Do Health Maintenance Organizations Work for Medicare?" Health Care Financing Review (Fall 1993): 7-23.
6. Physician Payment Review Commission, 1996 Annual Report to Congress (Washington: PPRC, 1996), 80-81.
7. Ibid.
8. The Physician Payment Review Commission (PPRC), in its 1996 Annual Report, calculated the change in a payment index for the county as a percentage of the county's average payment index over a five-year period. The payment index used was the ratio of the county's AAPCC rate to the national average rate per beneficiary. A different measure is used here, primarily because it is more intuitively understood, and because it more directly "de-trends" the growth in national average spending from changes in local area AAPCC rates.
9. Rural Policy Research Institute Rural Health Panel, "The Rural Implications of Medicare AAPCC Capitation Payment Changes," Congressional Briefing Document (Columbia, Mo.: RUPRI, 29 May 1997), 26-28.
10. Ibid., 32-33.
11. Medicare HMO Enrollment: Area Differences Affected by Factors Other than Payment Rates, GAO/HEHS-97-37 (Washington: U.S. General Accounting Office, May 1997); and Serrato et al., "Why Do So Few HMOs Offer Medicare Risk Plans?" 11. The authors are grateful to an anonymous reviewer for making this point.
12. Medicare HMO Enrollment: Area Differences Affected by Factors Other than Payment Rates, GAO/HEHS-97-37 (Washington: U.S. General Accounting Office, May 1997); and Serrato et al., "Why Do So Few HMOs Offer Medicare Risk Plans?" 11. The authors are grateful to an anonymous reviewer for making this point.