-
1
-
-
0347799670
-
Physician earnings at risk: An examination of capitated contracts
-
Simon CJ, Emmons DW: Physician earnings at risk: An examination of • capitated contracts. Health Affairs 1997, 16:120-126. Examines 1995 data from a national physician survey to document the prevalence of capitation overall and specifically by geographic region, specialty, and practice size. Also reports that some physicians are unaware of specific contract provisions, whereas others do not hold re-insurance policies to minimize excessive downside risk.
-
(1997)
Health Affairs
, vol.16
, pp. 120-126
-
-
Simon, C.J.1
Emmons, D.W.2
-
2
-
-
18544398934
-
New survey results: Managed-care participation and incomes keep rising
-
Terry K: New survey results: Managed-care participation and incomes keep rising. Med Econ 1996, 74:196-208.
-
(1996)
Med Econ
, vol.74
, pp. 196-208
-
-
Terry, K.1
-
3
-
-
15444344607
-
-
Regional Market Analysis. St. Paul, MN: InterStudy Publications
-
The InterStudy Competitive Edge Version 6.1, Part III: Regional Market Analysis. St. Paul, MN: InterStudy Publications; 1995.
-
(1995)
The InterStudy Competitive Edge Version 6.1
, Issue.3 PART
-
-
-
4
-
-
16044367812
-
Capitation or decapitation: Keeping your head in changing times
-
Bodenheimer TS, Grumbach K: Capitation or decapitation: Keeping your head in changing times. JAMA 1996, 276:1025-1031.
-
(1996)
JAMA
, vol.276
, pp. 1025-1031
-
-
Bodenheimer, T.S.1
Grumbach, K.2
-
5
-
-
0029561122
-
A national survey of the arrangements managed-care plans make with physicians
-
Gold MR, Hurley R, Lake T, Ensor T, Berenson R: A national survey of the arrangements managed-care plans make with physicians. N Engl J Med 1995, 333:1678-1683.
-
(1995)
N Engl J Med
, vol.333
, pp. 1678-1683
-
-
Gold, M.R.1
Hurley, R.2
Lake, T.3
Ensor, T.4
Berenson, R.5
-
6
-
-
0026349017
-
Managing the physician: Rules versus incentives
-
Hillman AL: Managing the physician: Rules versus incentives. Health Aff 1991, 10:138-146.
-
(1991)
Health Aff
, vol.10
, pp. 138-146
-
-
Hillman, A.L.1
-
7
-
-
1542714946
-
Reimbursing health plans and health providers: Efficiency in production versus selection
-
Newhouse JP: Reimbursing health plans and health providers: Efficiency in production versus selection. J Econ Lit 1996; 34:1236-1263.
-
(1996)
J Econ Lit
, vol.34
, pp. 1236-1263
-
-
Newhouse, J.P.1
-
9
-
-
0029563340
-
Protecting children with chronic illness in a competitive marketplace
-
Neff JM, Anderson GF: Protecting children with chronic illness in a competitive marketplace. JAMA 1995, 274:1866-1869.
-
(1995)
JAMA
, vol.274
, pp. 1866-1869
-
-
Neff, J.M.1
Anderson, G.F.2
-
10
-
-
0029901558
-
Capitation adjustment for pediatric populations
-
Fowler EJ, Anderson GF: Capitation adjustment for pediatric populations. Pediatrics 1996, 98:10-17.
-
(1996)
Pediatrics
, vol.98
, pp. 10-17
-
-
Fowler, E.J.1
Anderson, G.F.2
-
11
-
-
0023780301
-
Managed competition:an agenda for action
-
Enthoven AC: Managed competition:an agenda for action. Health Affairs 1988, 7:25-47.
-
(1988)
Health Affairs
, vol.7
, pp. 25-47
-
-
Enthoven, A.C.1
-
12
-
-
0028942635
-
Guiding principles for managed care arrangements for the health care of infants, children, adolescents, and young adults
-
Committee on Child Health Financing: Guiding principles for managed care arrangements for the health care of infants, children, adolescents, and young adults. Pediatrics 1995, 59:613-615.
-
(1995)
Pediatrics
, vol.59
, pp. 613-615
-
-
-
13
-
-
0344059759
-
Risk adjustment and Medicare: Taking a closer look
-
Newhouse JP, Buntin MB, Chapman JD: Risk adjustment and Medicare: •• Taking a closer look. Health Affairs 1997, 16:26-43. An excellent discussion of the need for risk adjustment in at-risk reimbursement systems and the inherent theoretical challenges of developing suitable adjusters for Medicare. Argues for a blended capitated system.
-
(1997)
Health Affairs
, vol.16
, pp. 26-43
-
-
Newhouse, J.P.1
Buntin, M.B.2
Chapman, J.D.3
-
14
-
-
0028905486
-
The impact of physician financial incentives on high-risk populations in managed care
-
Hillman AL: The impact of physician financial incentives on high-risk populations in managed care. J Acquir Immune Defic Syndr Hum Retrovirol 1995, 8(suppl 1):S23-S30.
-
(1995)
J Acquir Immune Defic Syndr Hum Retrovirol
, vol.8
, Issue.1 SUPPL.
-
-
Hillman, A.L.1
-
15
-
-
0031855741
-
Prevalence and impact of disabling chronic conditions in childhood
-
Newacheck PW, Halfon N. Prevalence and impact of disabling chronic conditions in childhood. AJPH 1998, 88:610-617.
-
(1998)
AJPH
, vol.88
, pp. 610-617
-
-
Newacheck, P.W.1
Halfon, N.2
-
16
-
-
0030743267
-
Ependitures for care of children with chronic illnesses enrolled in the Washington State Medicaid Program, fiscal year 1993
-
Ireys HT, Anderson GF, Shaffer TJ, Neff JM: Ependitures for care of chil••dren with chronic illnesses enrolled in the Washington State Medicaid Program, fiscal year 1993. Pediatrics 1997, 100:197-204. Summarizes claims data analysis for more than 300,000 children. Presents average fee-for-service cost data as well as average costs for a selection of eight chronic conditions. Also reports how monies were spent across various categories of service. Source for actual cost data.
-
(1997)
Pediatrics
, vol.100
, pp. 197-204
-
-
Ireys, H.T.1
Anderson, G.F.2
Shaffer, T.J.3
Neff, J.M.4
-
17
-
-
0025060233
-
Development of clinical and economic prognoses from Medicare claims data
-
Anderson G, Steinberg EP, Whittle J, Powe NR, Antebi S, Herbert R: Development of clinical and economic prognoses from Medicare claims data. JAMA 1990, 263:967-972.
-
(1990)
JAMA
, vol.263
, pp. 967-972
-
-
Anderson, G.1
Steinberg, E.P.2
Whittle, J.3
Powe, N.R.4
Antebi, S.5
Herbert, R.6
-
18
-
-
0029038891
-
The first 30 years of Medicare and Medicaid
-
DeLew N: The first 30 years of Medicare and Medicaid. JAMA 1995, 274:262-267.
-
(1995)
JAMA
, vol.274
, pp. 262-267
-
-
DeLew, N.1
-
19
-
-
0029941140
-
Diagnostic risk adjustment for Medicaid: The disability payment system
-
Kronick R, Dreyfus T, Lee L, Zhou Z: Diagnostic risk adjustment for Medicaid: The disability payment system. Health Care Financ Rev 1996, 17:7-33.
-
(1996)
Health Care Financ Rev
, vol.17
, pp. 7-33
-
-
Kronick, R.1
Dreyfus, T.2
Lee, L.3
Zhou, Z.4
-
20
-
-
0029151772
-
Assessing the quality of primary care: The use and importance of reimbursement data
-
Longo DR, Daugird AJ, Spencer DC: Assessing the quality of primary care: The use and importance of reimbursement data. J Health Care Financ 1995, 21:13-30.
-
(1995)
J Health Care Financ
, vol.21
, pp. 13-30
-
-
Longo, D.R.1
Daugird, A.J.2
Spencer, D.C.3
-
21
-
-
0024271154
-
Capitation payment: Using predictors of medical utilization to adjust rates
-
Epstein AM, Cumella EJ: Capitation payment: Using predictors of medical utilization to adjust rates. Health Care Financ Rev 1988, 10:51-69.
-
(1988)
Health Care Financ Rev
, vol.10
, pp. 51-69
-
-
Epstein, A.M.1
Cumella, E.J.2
-
22
-
-
0024337682
-
Adjusting capitation rates using objective health measures and prior utilization
-
Newhouse JP, Manning WG, Keeler EB, Sloss EM: Adjusting capitation rates using objective health measures and prior utilization. Health Care Financ Rev 1989, 10:41-54.
-
(1989)
Health Care Financ Rev
, vol.10
, pp. 41-54
-
-
Newhouse, J.P.1
Manning, W.G.2
Keeler, E.B.3
Sloss, E.M.4
-
23
-
-
0027812244
-
Risk adjustment for a children's capitation rate
-
Newhouse JP, Sloss EM, Manning WG, Keeler EB: Risk adjustment for a children's capitation rate. Health Care Financ Rev 1993, 15:39-54.
-
(1993)
Health Care Financ Rev
, vol.15
, pp. 39-54
-
-
Newhouse, J.P.1
Sloss, E.M.2
Manning, W.G.3
Keeler, E.B.4
-
24
-
-
0029950264
-
Risk adjusted Medicare capitation rates using ambulatory and inpatient diagnoses
-
Weiner J, Dobson A, Maxwell S, Coleman K, Starfield B, Anderson G: Risk adjusted Medicare capitation rates using ambulatory and inpatient diagnoses. Health Care Financ Rev 1996, 17:77-99.
-
(1996)
Health Care Financ Rev
, vol.17
, pp. 77-99
-
-
Weiner, J.1
Dobson, A.2
Maxwell, S.3
Coleman, K.4
Starfield, B.5
Anderson, G.6
-
25
-
-
0029909069
-
Taking health status into account when setting capitation rates
-
Fowles JB, Weiner JP, Knutson D, Fowler E, Tucker AM, Ireland M: Taking health status into account when setting capitation rates. JAMA 1996, 276:1316-1321.
-
(1996)
JAMA
, vol.276
, pp. 1316-1321
-
-
Fowles, J.B.1
Weiner, J.P.2
Knutson, D.3
Fowler, E.4
Tucker, A.M.5
Ireland, M.6
-
26
-
-
0030969407
-
Pediatric carve outs
-
Andrews J, Anderson GF, Han C, Neff J: Pediatric carve outs. Arch Pediatr • Adolesc Med 1997, 151:236-242. Identifies high-cost, low-variability conditions from the Washington State Medicaid database, fiscal year 1993, for potential use as disease-specific carve-outs. Reports both mean and total fee-for-service cost data for these conditions, while examining the effects of selected secondary diagnoses on costs.
-
(1997)
Arch Pediatr Adolesc Med
, vol.151
, pp. 236-242
-
-
Andrews, J.1
Anderson, G.F.2
Han, C.3
Neff, J.4
-
27
-
-
0029098001
-
Agreement between physicians' office records and Medicare part B claims data
-
Fowles JB, Lawthers A, Weiner J: Agreement between physicians' office records and Medicare part B claims data. Health Care Financ Rev 1995, 16:189-200.
-
(1995)
Health Care Financ Rev
, vol.16
, pp. 189-200
-
-
Fowles, J.B.1
Lawthers, A.2
Weiner, J.3
-
29
-
-
0030727498
-
Profiling the health service needs of populations: Description and uses of the NACHRI classification of congenital and chronic health conditions
-
Gay JC, Muldoon JH, Neff JM, Wing LJ: Profiling the health service • needs of populations: Description and uses of the NACHRI classification of congenital and chronic health conditions. Pediatr Ann 1997, 26:655-663. Details the workings of the risk adjustment method proposed by The National Association of Children's Hospitals and Related Institutions and summarizes its ability to predict costs when tested against the Washington State Medicaid database, fiscal years 1992 and 1993.
-
(1997)
Pediatr Ann
, vol.26
, pp. 655-663
-
-
Gay, J.C.1
Muldoon, J.H.2
Neff, J.M.3
Wing, L.J.4
-
30
-
-
0029971083
-
Diagnosis-based risk adjustment for Medicare capitation payments
-
Ellis RP, Pope GC, Iezzoni LI, Ayanian JZ, Bates DE, Burstin H, Ash AS: Diagnosis-based risk adjustment for Medicare capitation payments. Health Care Financ Rev 1996, Spring:101-128.
-
(1996)
Health Care Financ Rev
, vol.SPRING
, pp. 101-128
-
-
Ellis, R.P.1
Pope, G.C.2
Iezzoni, L.I.3
Ayanian, J.Z.4
Bates, D.E.5
Burstin, H.6
Ash, A.S.7
-
31
-
-
0029072948
-
Insuring the poor through Section 1115 Medicaid waivers
-
Holahan J, Coughlin T, Ku L, Lipson DJ, Rajan S: Insuring the poor through Section 1115 Medicaid waivers. Health Art 1995, 14:199-216.
-
(1995)
Health Art
, vol.14
, pp. 199-216
-
-
Holahan, J.1
Coughlin, T.2
Ku, L.3
Lipson, D.J.4
Rajan, S.5
-
32
-
-
0030855506
-
Primary care physicians' satisfaction with quality of care in California capitated medical groups
-
Kerr EA, Hays RD, Mittman BS, Siu AL, Leake B, Brook RH: Primary care •• physicians' satisfaction with quality of care in California capitated medical groups. JAMA 1997, 278:308-312. Surveyed 910 primary care physicians in California on their satisfaction with four aspects of the quality of care their capitated patients receive as compared with other patients in their practice. Interesting insight into the "front line" of capitated managed care.
-
(1997)
JAMA
, vol.278
, pp. 308-312
-
-
Kerr, E.A.1
Hays, R.D.2
Mittman, B.S.3
Siu, A.L.4
Leake, B.5
Brook, R.H.6
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