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Volumn 21, Issue 4, 1998, Pages 29-52

The development of a risk-adjusted capitation payment system: The Maryland Medicaid model

Author keywords

1115 waiver; Ambulatory care group; Capitation; Case mix; Health care financing; Medicaid; Risk adjustment

Indexed keywords

CAPITATION FEE; HEALTH CARE FINANCING; HEALTH PROGRAM; MANAGED CARE; MEDICAID; PRACTICE GUIDELINE; PROSPECTIVE PAYMENT; REVIEW; RISK ASSESSMENT;

EID: 0031709878     PISSN: 01489917     EISSN: None     Source Type: Journal    
DOI: 10.1097/00004479-199810000-00003     Document Type: Review
Times cited : (35)

References (24)
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    • Actuarial Research Corporation. (1996). Maryland Medicaid managed care program (1115 waiver). Annandale, VA: Author. (Available on-line from: Center for Health Program Development and Management, University of Maryland Baltimore County - www.umbc.edu/chpdm.)
    • (1996) Maryland Medicaid Managed Care Program (1115 Waiver)
  • 3
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    • Washington, DC: Author
    • American Association of Health Plans. (1995). 1995, Annual industry survey. Washington, DC: Author.
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  • 4
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    • Pediatric carve-outs: The use of disease-specific conditions as risk adjusters in capitated payment systems
    • Andrews, J., Anderson, G., Han, C., & Neff, J. (1997). Pediatric carve-outs: The use of disease-specific conditions as risk adjusters in capitated payment systems. Archives Pediatric Adolescent Medicine, 151, 236-242.
    • (1997) Archives Pediatric Adolescent Medicine , vol.151 , pp. 236-242
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  • 11
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    • December. Baltimore: Health Services Research and Development Center, Johns Hopkins University School of Public Health
    • Johns Hopkins University. (1997, December). The Johns Hopkins ACG case-mix system clinician's guide. Baltimore: Health Services Research and Development Center, Johns Hopkins University School of Public Health. (Available on-line - www.hsr.jhsph.edu/acg/acg.htm.)
    • (1997) The Johns Hopkins ACG Case-mix System Clinician's Guide
  • 13
    • 0029941140 scopus 로고    scopus 로고
    • Diagnostic risk adjustment for Medicaid: The disability payment system
    • Kronick, R., Dreufus, T., Lee, L., & Zhou, Z. (1996). Diagnostic risk adjustment for Medicaid: The disability payment system. Health Care Financing Review, 17(3), 7-33.
    • (1996) Health Care Financing Review , vol.17 , Issue.3 , pp. 7-33
    • Kronick, R.1    Dreufus, T.2    Lee, L.3    Zhou, Z.4
  • 14
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    • Potential methods to reduce risk selection and its effects
    • Luft, H. (1995). Potential methods to reduce risk selection and its effects. Inquiry, 32, 23-32.
    • (1995) Inquiry , vol.32 , pp. 23-32
    • Luft, H.1
  • 15
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    • Patients at risk: Health reform and risk adjustment
    • Newhouse, J. (1994). Patients at risk: Health reform and risk adjustment. Health Affairs, 13(1), 132-146.
    • (1994) Health Affairs , vol.13 , Issue.1 , pp. 132-146
    • Newhouse, J.1
  • 16
    • 0030216245 scopus 로고    scopus 로고
    • Systemwide provider performance in a Medicaid program: Profiling the care of patients with chronic illnesses
    • Powe, N., Weiner, J., Starfield, B., Stuart, M., Baker, A., & Steinwachs, D. (1996). Systemwide provider performance in a Medicaid program: Profiling the care of patients with chronic illnesses. Medical Care, 34(8), 798-810.
    • (1996) Medical Care , vol.34 , Issue.8 , pp. 798-810
    • Powe, N.1    Weiner, J.2    Starfield, B.3    Stuart, M.4    Baker, A.5    Steinwachs, D.6
  • 17
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    • Risk-adjusted physician compensation: A new frontier in managed care reimbursement
    • St. Anthony's. (1997). Risk-adjusted physician compensation: A new frontier in managed care reimbursement. St. Anthony's Physician Capitation Report, 3(6), 1-2.
    • (1997) St. Anthony's Physician Capitation Report , vol.3 , Issue.6 , pp. 1-2
  • 18
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    • Ambulatory care groups: A categorization for research and management
    • Starfield, B., Weiner, J., Mumford, B. L., & Steinwachs, D. (1991). Ambulatory care groups: A categorization for research and management. Health Services Research, 26(1), 53-74.
    • (1991) Health Services Research , vol.26 , Issue.1 , pp. 53-74
    • Starfield, B.1    Weiner, J.2    Mumford, B.L.3    Steinwachs, D.4
  • 19
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    • Patient mix differences among ambulatory providers and their effect on utilization and payment for Maryland Medicaid users
    • Stuart, M., & Steinwachs, D. (1993). Patient mix differences among ambulatory providers and their effect on utilization and payment for Maryland Medicaid users. Medical Care, 37, 1,119-1,137.
    • (1993) Medical Care , vol.37 , pp. 1119-1137
    • Stuart, M.1    Steinwachs, D.2
  • 20
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    • Profiling primary care physician resource use: Examining the application of case-mix adjustment
    • Tucker, A., Weiner, J., Honigfeld, S., & Parton, R. (1996). Profiling primary care physician resource use: Examining the application of case-mix adjustment. Journal of Ambulatory Care Management, 19(1), 60-80.
    • (1996) Journal of Ambulatory Care Management , vol.19 , Issue.1 , pp. 60-80
    • Tucker, A.1    Weiner, J.2    Honigfeld, S.3    Parton, R.4
  • 21
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    • Medicare and Medicaid Statistical Supplement, 1996
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    • (1996) Health Care Financing Review
  • 24
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    • Development and application of a population-oriented measure of ambulatory care case-mix
    • Weiner, J., Starfield, B., Steinwachs, D., & Mumford, L. (1991). Development and application of a population-oriented measure of ambulatory care case-mix. Medical Care, 29(5), 452-472.
    • (1991) Medical Care , vol.29 , Issue.5 , pp. 452-472
    • Weiner, J.1    Starfield, B.2    Steinwachs, D.3    Mumford, L.4


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.