Health Status of Medicare Enrollees in HMOs and Fee-for-Service in 1994

Health Care Financing Review

Volumn 17, Issue 4, 1996, Pages 65-76

  Riley, Gerald ^a   Tudor, Cynthia ^b   Chiang, Yen Pin ^b   Ingber, Melvin ^b  

^a Office of Research   (United States)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

AGED; ARTICLE; CAPITATION FEE; COMPARATIVE STUDY; DAILY LIFE ACTIVITY; EPIDEMIOLOGY; FEE; FEMALE; HEALTH MAINTENANCE ORGANIZATION; HEALTH SURVEY; HUMAN; LONGITUDINAL STUDY; MALE; MEDICAL FEE; MEDICARE; UNITED STATES; UTILIZATION REVIEW;

ACTIVITIES OF DAILY LIVING; AGED; CAPITATION FEE; FEE-FOR-SERVICE PLANS; FEMALE; HEALTH CARE SURVEYS; HEALTH MAINTENANCE ORGANIZATIONS; HEALTH STATUS INDICATORS; HUMANS; LONGITUDINAL STUDIES; MALE; MEDICARE; RATE SETTING AND REVIEW; UNITED STATES;

EID: 0030154232     PISSN: 01958631     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (26)

1. Adler, G.: A Profile of the Medicare Current Beneficiary Survey. Health Care Financing Review 15(4):153-163, Summer 1994.
2. Brown, R.S., Bergeron, J.W., Clement, D.G., et al.: The Medicare Risk Program for HMOs - Final Summary Report on Findings From the Evaluation. Final Report under HCFA Contract Number 500-88-0006. Princeton, NJ. Mathematica Policy Research, Inc., 1993.
3. Dowd, B., Feldman, R., Moscovice, I., et al.: An Analysis of Selectivity Bias in the AAPCC. Paper presented at the American Public Health Association Annual Meeting. San Francisco, CA. October 1993.
4. Eggers, P., and Prihoda, R.: Pre-Enrollment Reimbursement Patterns of Medicare Beneficiaries Enrolled in "At-Risk" HMOs. Health Care Financing Review 4(1):55-73, Fall 1982.
5. Ellis, R.P., Pope, G.C., Iezzoni, L.I., et al.: Diagnosis-Based Risk Adjustment for Medicare Capitation Payments. Health Care Financing Review 17(3):101-128, Spring 1996.
6. Epstein, A.M., and Cumella, E.J.: Capitation Payment: Using Predictors of Medical Utilization to Adjust Rates. Health Care Financing Review 10(1):51-69, Fall 1988.
7. Gruenberg, L., Kaganova, J., and Hornbrook, M.C.: Improving the AAPCC With Health-Status Measures From the MCBS. Health Care Financing Review 17(3):59-75, Spring 1996.
8. Gruenberg, L.: Personal communication. DataChron Health Systems. Cambridge, MA. 1996.
9. Hellinger, F.: Selection Bias in HMOs and PPOs: A Review of the Evidence. Inquiry 32:135-142, Summer 1995.
10. Hill, J., and Brown, R.: Health Status, Financial Barriers, and the Decision to Enroll in Medicare Risk Plans. Report under HCFA Contract Number 500-88-0066. Princeton, NJ. Mathematica Policy Research, Inc., December 1992.
11. Hornbrook, M.C., Greenlick, M.R., Bennett, M.D., and Goodman, M.J.: Determination of Capitation Payment Rates for Medicare HMO Beneficiaries. Final Report under HCFA Cooperative Agreement Number 18-C-98804-1. Portland, OR Kaiser Permanente, 1993.
12. Rowland, J., Stokes, J., Crane, S.C., and Belanger, A.J.: Adjusting Capitation Using Chronic Disease Risk Factors: A Preliminary Study. Health Care Financing Review 9(2):15-23, Winter 1987.
13. Kasper, J.D., Riley, G.F., McCombs, J.S., and Stevenson, M.A.: Beneficiary Selection, Use, and Charges in Two Medicare Capitation Demonstrations. Health Care Financing Review 10(1):37-49, Fall 1988.
14. Kasper, J., Campbell, D., and Gutierrez-Mohamed, M.L.: Patterns of Nonresponse and Retention in the First Four Rounds of the MCBS. Baltimore, MD. The Johns Hopkins University, July 1994.
15. Lichtenstein, R., Thomas, J.W., Adams-Watson, J., et al.: Selection Bias in TEFRA At-Risk HMOs. Medical Care 29(4):318-331, April 1991.
16. Lubitz, J., Beebe, J., and Riley, G.: Improving the Medicare HMO Payment Formula to Deal With Biased Selection. In Scheffler, R., and Rossiter, L., eds: Advances in Health Economics and Health Services Research. Vol. 6. Greenwich, CT. JAI Press, 1985.
17. Lubitz, J.: Health Status Adjustments for Medicare Capitation. Inquiry 24:362-375, Winter 1987.
18. Physician Payment Review Commission: A Comparison of Alternative Approaches to Risk Measurement. Final Report Under Grant Number 93-G07. Minneapolis, MN. Park Nicollet Medical Foundation, 1994.
19. Physician Payment Review Commission: Annual Report to Congress. Washington, DC.. 1996.
20. Price Waterhouse: Is There Biased Selection in Medicare HMOs? Washington, DC.: March 1996.
21. Retchin, S.M., Clement D.G., Rossiter, L.F., et al.: How the Elderly Fare in HMOs: Outcomes From the Medicare Competition Demonstrations. HSR: Health Services Research 27(5):651-669, December 1992.
22. Riley, G., Lubitz, J., and Rabey, E.: Enrollee Health Status Under Medicare Risk Contracts: An Analysis of Mortality Rates. HSR: Health Services Research 26(2):137-163, June 1991.
23. Riley, G., Rabey, E., and Kasper, J.: Biased Selection and Regression Toward the Mean in Three Medicare HMO Demonstrations: A Survival Analysis of Enrollees and Disenrollees. Medical Care 27(4):337-351, April 1989.
24. Thomas, J.W., and Lichtenstein, R.L.: Functional Health Measures for Adjusting Health Maintenance Organization Capitation Rates. Health Care Financing Review 7(3):85-95, Spring 1986.
25. Weiner, J.P., Dobson, A., Maxwell, S.M., et al.: Risk-Adjusted Medicare Capitation Rates Using Ambulatory and Inpatient Diagnoses. Health Care Financing Review 17(3):77-99, Spring 1996.
26. Welch, W.P.: Medicare Capitation Payments to HMOs in Light of Regression Toward the Mean in Health Care Costs. In Scheffler, R., and Rossiter, L., eds.: Advances in Health Economics and Health Services Research. Vol. 6. Greenwich, CT. JAI Press, 1985.