메뉴 건너뛰기




Volumn 41, Issue 1, 2003, Pages 56-69

The best of both worlds?: Potential of hybrid prospective/concurrent risk adjustment

Author keywords

Auditing; Chronic disease; Health care financing; Risk adjustment; Risk assessment

Indexed keywords

ADOLESCENT; ADULT; ARTICLE; CHRONIC DISEASE; COMPARATIVE STUDY; DIAGNOSIS RELATED GROUP; FEMALE; FORECASTING; HEALTH CARE COST; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; HUMAN; INFORMATION PROCESSING; MALE; MEDICAL AUDIT; MEDICAL FEE; MEDICARE; MIDDLE AGED; PROSPECTIVE STUDY; RISK ASSESSMENT; STATISTICAL MODEL;

EID: 0037267230     PISSN: 00257079     EISSN: None     Source Type: Journal    
DOI: 10.1097/00005650-200301000-00009     Document Type: Article
Times cited : (29)

References (26)
  • 1
    • 0033782246 scopus 로고    scopus 로고
    • Improving health-based payment for Medicaid beneficiaries: CDPS
    • Kronick R, Gilmer T, Dreyfus T, et al. Improving health-based payment for Medicaid beneficiaries: CDPS. Health Care Financ Rev 2000;21:29-64.
    • (2000) Health Care Financ Rev , vol.21 , pp. 29-64
    • Kronick, R.1    Gilmer, T.2    Dreyfus, T.3
  • 2
    • 0034694878 scopus 로고    scopus 로고
    • From the Health Care Financing Administration: Medicare + Choice Plans
    • Hash M. From the Health Care Financing Administration: Medicare + Choice Plans. JAMA 2000;284:2988.
    • (2000) JAMA , vol.284 , pp. 2988
    • Hash, M.1
  • 3
    • 0031905056 scopus 로고    scopus 로고
    • Case study: The Minneapolis Buyers Health Care Action Group
    • Knutson D. Case study: the Minneapolis Buyers Health Care Action Group. Inquiry 1998;35:171-177.
    • (1998) Inquiry , vol.35 , pp. 171-177
    • Knutson, D.1
  • 4
    • 0033789767 scopus 로고    scopus 로고
    • A clinically detailed risk information system for cost
    • Carter GM, Bell RM, Dubois RW, et al. A clinically detailed risk information system for cost. Health Care Financ Rev 2000;21:65-91.
    • (2000) Health Care Financ Rev , vol.21 , pp. 65-91
    • Carter, G.M.1    Bell, R.M.2    Dubois, R.W.3
  • 5
    • 0029971083 scopus 로고    scopus 로고
    • Diagnosis-based risk adjustment for Medicare capitation payments
    • Ellis RP, Pope GC, Iezzoni L, et al. Diagnosis-based risk adjustment for Medicare capitation payments. Health Care Financ Rev 1996;17:101-128.
    • (1996) Health Care Financ Rev , vol.17 , pp. 101-128
    • Ellis, R.P.1    Pope, G.C.2    Iezzoni, L.3
  • 6
    • 0029941140 scopus 로고    scopus 로고
    • Diagnostic risk adjustment for Medicaid: The disability payment system
    • Kronick R, Dreyfus T, Lee L, et al. 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
  • 7
    • 0033173312 scopus 로고    scopus 로고
    • The sensitivity and specificity of forecasting high-cost users of medical care
    • Meenan RT, O'Keeffe-Rosetti C, Hombrook MC, et al. The sensitivity and specificity of forecasting high-cost users of medical care. Med Care 1999;37:815-823.
    • (1999) Med Care , vol.37 , pp. 815-823
    • Meenan, R.T.1    O'Keeffe-Rosetti, C.2    Hombrook, M.C.3
  • 8
    • 0029950264 scopus 로고    scopus 로고
    • Risk-adjusted Medicare capitation rates using ambulatory and inpatient diagnoses
    • Weiner JP, Dobson A, Maxwell SL, et al. 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.P.1    Dobson, A.2    Maxwell, S.L.3
  • 9
    • 0031659356 scopus 로고    scopus 로고
    • Physician profiling using outpatient pharmacy data as a source for case mix measurement and risk adjustment
    • Roblin DW. Physician profiling using outpatient pharmacy data as a source for case mix measurement and risk adjustment. J Ambul Care Manage 1998;21:68-84.
    • (1998) J Ambul Care Manage , vol.21 , pp. 68-84
    • Roblin, D.W.1
  • 10
    • 0035513625 scopus 로고    scopus 로고
    • The Medicaid Rx model: Pharmacy-based risk adjustment for public programs
    • Gilmer T, Kronick R, Fishman P, et al. The Medicaid Rx model: Pharmacy-based risk adjustment for public programs. Med Care 2001;39:1188-1202.
    • (2001) Med Care , vol.39 , pp. 1188-1202
    • Gilmer, T.1    Kronick, R.2    Fishman, P.3
  • 11
    • 0035516178 scopus 로고    scopus 로고
    • Characteristics of adult primary care patients as predictors of future health services charges
    • Parkerson GR, Jr., Harrell FE, Hammond WE, et al. Characteristics of adult primary care patients as predictors of future health services charges. Med Care 2001;39:1170-1181.
    • (2001) Med Care , vol.39 , pp. 1170-1181
    • Parkerson Jr., G.R.1    Harrell, F.E.2    Hammond, W.E.3
  • 12
  • 13
    • 0024337682 scopus 로고
    • Adjusting capitation rates using objective health measures and prior utilization
    • Newhouse JP, Manning WG, Keeler EB, et al. 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
  • 14
    • 0034897203 scopus 로고    scopus 로고
    • Risk adjustment alternatives in paying for behavioral health care under Medicaid
    • Ettner SL, Frank RG, McGuire TG, et al. Risk adjustment alternatives in paying for behavioral health care under Medicaid. Health Serv Res 2001;36:793-811.
    • (2001) Health Serv Res , vol.36 , pp. 793-811
    • Ettner, S.L.1    Frank, R.G.2    McGuire, T.G.3
  • 15
    • 0032184933 scopus 로고    scopus 로고
    • The high costs of death: Should health plans get higher payments when members die?
    • van Vliet RC, Lamers LM. The high costs of death: should health plans get higher payments when members die? Med Care 1998;36:1451-1460.
    • (1998) Med Care , vol.36 , pp. 1451-1460
    • van Vliet, R.C.1    Lamers, L.M.2
  • 16
    • 0026606828 scopus 로고
    • Medicare use in the last ninety days of life
    • Gaumer GL, Stavins J. Medicare use in the last ninety days of life. Health Serv Res 1992;26:725-742.
    • (1992) Health Serv Res , vol.26 , pp. 725-742
    • Gaumer, G.L.1    Stavins, J.2
  • 17
    • 0028196831 scopus 로고
    • Patients at risk: Health reform and risk adjustment
    • Newhouse JP. Patients at risk: Health reform and risk adjustment. Health Aff 1994;13:132-146.
    • (1994) Health Aff , vol.13 , pp. 132-146
    • Newhouse, J.P.1
  • 18
    • 0033838155 scopus 로고    scopus 로고
    • Discretionary hospital use and diagnostic risk adjustment of Medicare HMO capitation rates
    • Porell FW, Gruenberg L. Discretionary hospital use and diagnostic risk adjustment of Medicare HMO capitation rates. Inquiry 2000;37:162-172
    • (2000) Inquiry , vol.37 , pp. 162-172
    • Porell, F.W.1    Gruenberg, L.2
  • 19
    • 0033819844 scopus 로고    scopus 로고
    • Medicaid managed care reimbursement for HIV and its implications for access to care
    • Conviser R, Murray M, Lau D. Medicaid managed care reimbursement for HIV and its implications for access to care. Am J Manag Care 2000;6:990-999.
    • (2000) Am J Manag Care , vol.6 , pp. 990-999
    • Conviser, R.1    Murray, M.2    Lau, D.3
  • 20
    • 0033531089 scopus 로고    scopus 로고
    • Geographic variations in utilization rates in Veterans Affairs hospitals and clinics
    • Ashton CM, Petersen NJ, Souchek J, et al. Geographic variations in utilization rates in Veterans Affairs hospitals and clinics. N Engl J Med 1999;340:32-39.
    • (1999) N Engl J Med , vol.340 , pp. 32-39
    • Ashton, C.M.1    Petersen, N.J.2    Souchek, J.3
  • 21
    • 0032089160 scopus 로고    scopus 로고
    • Profiling outcomes of ambulatory care: Casemix affects perceived performance
    • Berlowitz DR, Ash AS, Hickey EC, et al. Profiling outcomes of ambulatory care: Casemix affects perceived performance. Med Care 1998;36:928-933.
    • (1998) Med Care , vol.36 , pp. 928-933
    • Berlowitz, D.R.1    Ash, A.S.2    Hickey, E.C.3
  • 22
    • 0032254163 scopus 로고    scopus 로고
    • Interpreting risk-adjusted length of stay patterns for VA hospitals
    • Thomas JW, Bates EW, Hofer T, et al. Interpreting risk-adjusted length of stay patterns for VA hospitals. Med Care 1998;36:1660-1675.
    • (1998) Med Care , vol.36 , pp. 1660-1675
    • Thomas, J.W.1    Bates, E.W.2    Hofer, T.3
  • 23
    • 0033847214 scopus 로고    scopus 로고
    • The impact of disease management on outcomes and cost of care: A study of low-income asthma patients
    • Rossiter LF, Whitehurst-Cook MY, Small RE, et al. The impact of disease management on outcomes and cost of care: a study of low-income asthma patients. Inquiry 2000;37:188-202.
    • (2000) Inquiry , vol.37 , pp. 188-202
    • Rossiter, L.F.1    Whitehurst-Cook, M.Y.2    Small, R.E.3
  • 24
    • 0029909069 scopus 로고    scopus 로고
    • Taking health status into account when setting capitation rates: A comparison of risk-adjustment methods
    • Fowles JB, Weiner JP, Knutson D, et al. Taking health status into account when setting capitation rates: A comparison of risk-adjustment methods. JAMA 1996;276:1316-1321.
    • (1996) JAMA , vol.276 , pp. 1316-1321
    • Fowles, J.B.1    Weiner, J.P.2    Knutson, D.3
  • 25
    • 0029940234 scopus 로고    scopus 로고
    • Modified capitation and treatment incentives for end stage renal disease
    • Farley DO, Carter GM, Kailich JD, et al. Modified capitation and treatment incentives for end stage renal disease. Health Care Financ Rev 1996;17:129-142.
    • (1996) Health Care Financ Rev , vol.17 , pp. 129-142
    • Farley, D.O.1    Carter, G.M.2    Kailich, J.D.3


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.