Diagnosis-based risk adjustment for medicare prescription drug plan payments

Health Care Financing Review

Volumn 28, Issue 4, 2007, Pages 15-30

  Robst, John ^a   Levy, Jesse M ^b   Ingber, Melvin J ^c  

^a UNIVERSITY OF SOUTH FLORIDA   (United States)

^b CENTERS FOR MEDICARE AND MEDICAID SERVICES   (United States)

^c RTI INTERNATIONAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST; DIAGNOSIS RELATED GROUP; GOVERNMENT; LAW; LOWEST INCOME GROUP; MEDICAID; MEDICARE; PRESCRIPTION; PROSPECTIVE PAYMENT; RISK ASSESSMENT; STATISTICS;

AGED; AGED, 80 AND OVER; DIAGNOSIS-RELATED GROUPS; FEMALE; HUMANS; INSURANCE, PHARMACEUTICAL SERVICES; MALE; MEDICARE; PRESCRIPTIONS, DRUG; RISK ADJUSTMENT; UNITED STATES;

EID: 34547475613     PISSN: 01958631     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (4)

1. Centers for Disease Control and Prevention: International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Internet address: http://www.cdc.gov/nchs/about/otheract/icd9/ abticd9.htm (Accessed 2007.)
2. Gilmer, T., Kronick, R., Fishman, P., et al.: The Medicaid Rx Model: Pharmacy-Based Risk Adjustment for Public Programs. Medical Care 39(11):1188-1202, November 2001.
3. Wrobel, M.V., Doshi, J., Stuart, B.C., et al.: Predictability of Prescription Drug Expenditures for Medicare Beneficiaries. Health Care Financing Review 25(2):37-46, Winter 2003/2004.
4. Zhao, Z., Ash, A.S., Ellis, R.P., et al.: Predicting Pharmacy Costs and Other Medical Costs Using Diagnoses and Drug Claims. Medical Care 43(1):34-43, January 2005.