Comparison of risk-adjustment systems for the Medicaid-eligible disabled population

Medical Care

Volumn 38, Issue 4, 2000, Pages 422-432

  Payne, Susan M C ^a,b,d   Cebul, Randall D ^a,b   Singer, Mendel E ^a,b   Krishnaswamy, Jaikumar ^a   Gharrity, Katherine ^c  

^a CASE WESTERN RESERVE UNIVERSITY SCHOOL OF MEDICINE   (United States)

^b METROHEALTH MEDICAL CENTER   (United States)

^c Bureau of Medicaid Policy   (United States)

^d Health Institute   (United States)

Author keywords

Administrative data; Disabled; Medicaid; Risk adjustment

Indexed keywords

ADOLESCENT; ADULT; ARTICLE; CAPITATION FEE; CHILD; COHORT ANALYSIS; COMPARATIVE STUDY; DISABLED PERSON; ECONOMICS; FEMALE; HEALTH INSURANCE; HUMAN; INFANT; MALE; MEDICAID; MIDDLE AGED; ORGANIZATION AND MANAGEMENT; PRESCHOOL CHILD; RETROSPECTIVE STUDY; RISK ASSESSMENT; STATISTICS; UNITED STATES;

ADOLESCENT; ADULT; CAPITATION FEE; CHILD; CHILD, PRESCHOOL; COHORT STUDIES; DISABLED PERSONS; ELIGIBILITY DETERMINATION; FEMALE; HUMANS; INFANT; MALE; MANAGED CARE PROGRAMS; MEDICAID; MIDDLE AGED; OHIO; RETROSPECTIVE STUDIES; RISK ADJUSTMENT; UNITED STATES;

EID: 0034170867     PISSN: 00257079     EISSN: None     Source Type: Journal    
DOI: 10.1097/00005650-200004000-00009     Document Type: Article

References (18)

1. Medicare and Medicaid statistical supplement: Health care financing review. Baltimore, Md: US Department of Health and Human Services, Health Care Financing Administration; 1997. Publication No. 03399.
2. Holohan J, Zuckerman S, Evans A, Rangarajan S. Medicaid managed care in thirteen states. Health Aff 1998;17:43-63.
3. Hurley RE, Freund DA, Paul JE. Lessons for a decade of discussion and confusion: Managed care in Medicaid: Lessons for policy and program design. Ann Arbor, Mich: Health Administration Press; 1993:1-8.
4. Ash AS, Porell F, Gruenberg L, Sawitz E, Beiser A. Adjusting Medicare capitation payments using prior hospitalization data. Health Care Financing Rev 1989;10:17-30.
5. Ellis RP, Ash A. Refinements to the diagnostic cost group (DCG) model. Inquiry 1995-1996;32:418-429.
6. Epstein A, Cumella EJ. Capitation payment: Using predictors of medical utilization to adjust rates. Health Care Financing Rev 1988;10:51-70.
7. Newhouse JP, Manning WG, Keeler EJ, Loss EM. Adjusting capitation rates using objective health measures and prior utilization. Health Care Financing Rev 1989;10:41-53.
8. Hornbrook M, Goodman MJ. Chronic disease, functional health status, and demographics: A multi-dimensional approach to risk adjustment. Health Serv Res 1996;31:283-307.
9. Fowles JB, Weiner JP, Knutson D, Fowler E, Tucker AM, Ireland M. Taking health status into account when setting capitation rates: A comparison of risk-adjustment methods. JAMA 1996;276:1316-1321.
10. Kronick R, Chou H, Dreyfus T. Making risk adjustment work for everyone. Inquiry 1995;12:41-55.
11. Kronick R, Dreyfus L, Lee L, Chou Z. Diagnostic risk adjustment for Medicaid: The Disability Payment System. Health Care Financing Rev 1996;17:7-33.
12. Documentation of ABC project rate setting. Columbus, Ohio: Ohio Department of Human Services, Bureau of Medicaid Policy; August 1994:5.
13. ABC project final rates for SFY95. Columbus, Ohio: Ohio Department of Human Services, Bureau of Medicaid Policy; July 1995:17.
14. Ash A, Shwartz M. Evaluating the performance of risk-adjustment methods: Dichotomous measures. In: lezzoni L, ed. Risk adjustment for measuring health care outcomes. Ann Arbor, Mich: Health Administration Press; 1997:431-432.
15. Shwartz M, Ash A. Evaluating the performance of risk-adjustment methods: Continuous measures. In: Iezzoni L, ed. Risk adjustment for measuring health care outcomes. Ann Arbor, Mich: Health Administration Press; 1997:418-419.
16. Ash A, Ellis R, Yu W, Mackay E, lezzoni L, Ayanian J, et al. Risk adjustment for the non-elderly. Boston, Mass: Boston University Medical Center; 1998. Report to HCFA, contract No. 18-C-90462/ 1-02.
17. Korbin L, Long SK, Aragon C. Does health status explain higher Medicare costs of Medicaid enrollees? Health Care Financing Rev 1998;20:39-54.
18. Hornbrook MC, Goodman MJ. Health plan case mix: Definition, measurement, and use. In: Hornbrook MC. Advances in health economics and health services research. Greenwich, Conn: JAI Press Inc; 1991;12:111-148.