Health-based payment for HIV/AIDS in Medicaid managed care programs

Health Care Financing Review

Volumn 19, Issue 3, 1998, Pages 63-82

  Conviser, Richard ^a   Gamliel, Sandy ^b   Honberg, Lynda ^b  

^a HEALTH RESOURCES AND SERVICES ADMINISTRATION   (United States)

^b NONE

Author keywords

[No Author keywords available]

Indexed keywords

ACQUIRED IMMUNE DEFICIENCY SYNDROME; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HEALTH PROGRAM; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; MANAGED CARE; MANAGED CARE ORGANIZATION; MEDICAID; REVIEW;

CAPITATION FEE; HEALTH STATUS INDICATORS; HIV INFECTIONS; HUMANS; INSURANCE, DISABILITY; MANAGED CARE PROGRAMS; MEDICAID; MODELS, ORGANIZATIONAL; PATIENT ADVOCACY; PROGRAM EVALUATION; QUALITY OF HEALTH CARE; RATE SETTING AND REVIEW; STATE HEALTH PLANS; UNITED STATES; UNITED STATES CENTERS FOR MEDICARE AND MEDICAID SERVICES;

EID: 0031739201     PISSN: 01958631     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (28)

1. Ash, A., Porell, F., Gruenberg, L., et al.: An Analysis of Alternative AAPCC Models Using Data from the Continuous Medicare History Sample. Contract Number 99-C-98526/1, Health Policy Research Consortium, Brandeis University and Boston University. Baltimore, MD. Health Care Financing Administration, September 1986.
2. Ash, A., Porell, F., Gruenberg, L, et al.: Adjusting Medicare Capitation Payments Using Prior Hospitalization. Health Care Financing Review 10(4):17-29, 1989.
3. Bodenheimer, T.: The Oregon Health Plan-Lessons for the Nation. The New England Journal of Medicine 337(9):651-655 and 337(10):720-723, August 28 and September 4, 1997.
4. Bodenheimer, T.: The Oregon Health Plan-Lessons for the Nation. The New England Journal of Medicine 337(9):651-655 and 337(10):720-723, August 28 and September 4, 1997.
5. Conviser, R., Aschman, D., et al.: HIV Capitation Risk Adjustment: Conference Report, Washington, DC. Kaiser Family Foundation, 1997a.
6. Conviser, R., Amaya, M.A., Harris, J.A., and Gates, J.D.: The Role of Physician Experience and Training in Providing Access to Protease Inhibitors. Paper presented at the American Public Health Association annual meeting. Indianapolis, IN. November 1997b.
7. Conviser, R., Kerrigan, D., and Thompson, S.: The Adequacy of Reimbursement for HIV under Section 1115 Medicaid Waivers. AIDS & Public Policy Journal 12(3):112-127, Fall 1997.
8. Dreyfus, T., Kronick, R., Tobias, C.: Using Payment to Promote Better Medicaid Managed Care for People with AIDS. Portland, ME. National Academy for State Health Policy, 1997.
9. Dunn, D.L.: Applications of Health Risk Adjustment: What Can Be Learned From Experience To Date? Inquiry 35:132-147, Summer 1998.
10. Ellis, R.P., et al.: Diagnosis-Based Risk Adjustment for Medicare Capitation Payments. Health Care Financing Review 17(3):101-128, Spring 1996.
11. Ellis, R.P., and Ash, A.: Refinements to the Diagnostic Cost Group (DCG) Model. Inquiry 32:418-29, Winter 1995/96.
12. Gearon, C.J., ed.: Status of 17 State Medicaid Programs Under Section 1115 Waivers. News and Strategies for Managed Medicare & Medicaid 3(31):3-4, September 8, 1997.
13. Health Economics Program: Risk Adjustment and Rate Setting Methods in Public Programs: A Report to Legislature. St. Paul, MN. Minnesota Department of Health, January 1998.
14. Johns Hopkins University: Clinician's Guide: The Johns Hopkins University ACG Case-Mix Adjustment System, Version 4.0. Baltimore, MD. March 1997.
15. Kaiser Commission on the Future of Medicaid: Where is Medicaid Spending Headed? Washington, DC. December 1996.
16. Kitahata, M.M., et al.: Physicians' Experience with the Acquired Immunodeficiency Syndrome as a Factor in Patients' Survival. New England Journal of Medicine 334(11):701-706, March 14, 1996.
17. Korenbrot, C., Miller, G., and Greene, J.: Effects of Medicaid Managed Care on Community Clinics in California. Paper presented at the annual meeting of the Association for Health Services Research. Washington, DC. June 1998.
18. Kronick, R., et al.: Diagnostic Risk Adjustment for Medicaid: The Disability Payment System. Health Care Financing Review 17(3):7-33, Spring 1996.
19. Kronick, R., and Dreyfus, T.: The Challenge of Risk Adjustment for People with Disabilities: Health-Based Payment for Medicaid Programs. Princeton, NJ: Center for Health Care Strategies, November 1997.
20. Lee, C., and Rogal, D.: Risk Adjustment: A Key to Changing Incentives in the Health Insurance Market. Washington, DC. Alpha Center, 1997.
21. Moore, R.D., and Chaisson, R.E.: Costs to Medicaid of Advancing Immunosuppression in an Urban HIV-Infected Patient Population in Maryland. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology 14(3):223-31, March 1997.
22. Newhouse, J.P.: Risk Adjustment: Where Are We Now? Inquiry 35:122-131, Summer 1998.
23. Palella, F.J., Delaney, K.M., Moorman, A.C., et al.: Declining morbidity and mortality among patients with advanced Human Immunodeficiency Virus infection. The New England Journal of Medicine 338(13):853-860, March 26, 1998.
24. Payne, S.M., Cobul, R.D., Singer, M.D., et al.: Prior Use and Diagnoses as Risk Adjusters for the Medicaid Disabled. Paper presented at the annual meeting of the Association for Health Services Research. Washington, DC. June 1998.
25. Pearce, C.L.: Personal communication. Los Angeles. July 1998.
26. Tollen, L., and Rothman, M.: Case Study: Colorado Medicaid HMO Risk Adjustment. Inquiry 35:154-170, Summer 1998.
27. Watts, R.: Washington State's Experience with Medicaid Capitation for the Disabled Population. Paper presented at the AiC Conference on Capitating HIV/AIDS Services for Managed Care. San Francisco. June 1998.
28. Weiner, J.P., et al.: Risk-Adjusted Medicare Capitation Rates Using Ambulatory and Inpatient Diagnoses. Health Care Financing Review 17(3):77-99, Spring 1996.