Outpatient encounter data for risk adjustment: Strategic issues for medicare and medicaid

Journal of Ambulatory Care Management

Volumn 25, Issue 3, 2002, Pages 1-15

  Welch, W Pete ^a  

^a Mid Atlantic Medical Services Inc   (United States)

Author keywords

Ambulatory care; Chronic disease; Encounter records; HMOs; Information systems; Managed care; Risk adjustment

Indexed keywords

ARTHRITIS; CARDIOVASCULAR DISEASE; CHRONIC DISEASE; CHRONIC OBSTRUCTIVE LUNG DISEASE; CONGESTIVE HEART FAILURE; DIABETES MELLITUS; DIAGNOSTIC TEST; ECHOCARDIOGRAPHY; GEOGRAPHIC DISTRIBUTION; HEALTH CARE COST; HEALTH MAINTENANCE ORGANIZATION; HUMAN; INFORMATION SYSTEM; ISCHEMIC HEART DISEASE; MAJOR CLINICAL STUDY; MANAGED CARE; MEDICAID; MEDICAL RECORD; MEDICARE; OUTPATIENT CARE; PHYSICIAN; REVIEW; RISK ASSESSMENT;

EID: 0036283947     PISSN: 01489917     EISSN: None     Source Type: Journal    
DOI: 10.1097/00004479-200207000-00002     Document Type: Review

References (20)

1. Advances in diagnostic imaging and overestimations of disease prevalence and the benefits of therapy
2. The utility of Medicare claims data for measuring cancer stage
3. Paying plans to care for people with chronic illness
4. Blending prospective and concurrent risk adjustment to improve predictive accuracy and reduce gaming: A focus on verifiable, expensive, predictive conditions
5. Development and estimation of a pediatric chronic disease score using automated pharmacy data
6. Agreement between physicians' office records and Medicare Part B claims data
7. Validation of claims diagnoses and self-reported conditions compared with medical records for selected chronic diseases
8. Health-based payment catches on in state Medicaid programs
9. Health-based payment and computerized patient record systems
10. Assessing quality using administrative data
11. Improving health-based payment for Medicaid beneficiaries: CDPS
12. A comparison of ambulatory Medicaid claims to medical records: A reliability assessment
13. Case study: Colorado Medicaid HMO risk adjustment
14. Disease management practice of health plans