메뉴 건너뛰기




Volumn 50, Issue 2, 2012, Pages 140-144

Improving risk equalization using multiple-year high cost as a health indicator

Author keywords

claims data; efficiency; health insurance; risk equalization; risk selection

Indexed keywords

ACCURACY; ARTICLE; CHRONIC DISEASE; CLINICAL INDICATOR; COMPENSATION; CONTINUOUS PROSPECTIVE COMPENSATION; COST CONTROL; FIXED PROSPECTIVE COMPENSATION; HEALTH CARE COST; HEALTH CARE PLANNING; HEALTH INSURANCE; HUMAN; MATHEMATICAL MODEL; MEDICAL INFORMATION; NETHERLANDS; PREDICTIVE VALUE; PRIORITY JOURNAL; RETROSPECTIVE COMPENSATION; RISK ASSESSMENT; RISK EQUALIZATION MODEL;

EID: 84856053868     PISSN: 00257079     EISSN: 15371948     Source Type: Journal    
DOI: 10.1097/MLR.0b013e31822ebf8b     Document Type: Article
Times cited : (25)

References (23)
  • 1
    • 77956769711 scopus 로고    scopus 로고
    • Risk adjustment in competitive health insurance markets
    • Culyer AJ Newhouse JP eds. North-Holland: Amsterdam
    • Van de Ven WPMM, Ellis RP. Risk adjustment in competitive health insurance markets. In: Culyer AJ, Newhouse JP, eds. North-Holland: Amsterdam: Handbook of Health Economics; 2000:755-845.
    • (2000) Handbook of Health Economics , pp. 755-845
    • Van De Ven, W.P.M.M.1    Ellis, R.P.2
  • 2
    • 0033789768 scopus 로고    scopus 로고
    • Principal inpatient diagnostic cost group model for medicare risk adjustment
    • Pope GC, Ellis RP, Ash AS, et al. Principal Inpatient Diagnostic Cost Group Model for Medicare Risk Adjustment. Health Care Financ Rev. 2000;21:93-118.
    • (2000) Health Care Financ Rev , vol.21 , pp. 93-118
    • Pope, G.C.1    Ellis, R.P.2    Ash, A.S.3
  • 4
    • 0033782246 scopus 로고    scopus 로고
    • Improving health-based payments for Medicaid beneficiaries: CDPS
    • Kronick R, Gilmer T, Dreyfus T, et al. Improving health-based payments 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
  • 5
    • 0031903817 scopus 로고    scopus 로고
    • Risk-adjusted capitation payments: Developing a diagnostic cost groups classification for the Dutch situation
    • DOI 10.1016/S0168-8510(98)00031-1, PII S0168851098000311
    • Lamers LM. Risk-adjusted capitation payments: developing a diagnostic cost groups classification for the Dutch situation. Health Policy. 1998;45:15-32. (Pubitemid 28375732)
    • (1998) Health Policy , vol.45 , Issue.1 , pp. 15-32
    • Lamers, L.M.1
  • 6
    • 39649085109 scopus 로고    scopus 로고
    • Health-based risk adjustment: Improving the pharmacy-based cost group model by adding diagnostic cost groups
    • Prinsze FJ, Van Vliet RCJA. Health-based risk adjustment: improving the pharmacy-based cost group model by adding diagnostic cost groups. Inquiry. 2007;44:469-480. (Pubitemid 351287215)
    • (2007) Inquiry , vol.44 , Issue.4 , pp. 469-480
    • Prinsze, F.J.1    Van Vliet, R.C.J.A.2
  • 7
    • 0033176264 scopus 로고    scopus 로고
    • Pharmacy Costs Groups: A risk-adjuster for capitation payments based on the use of prescribed drugs
    • Lamers LM. Pharmacy Costs Groups: A risk-adjuster for capitation payments based on the use of prescribed drugs. Med Care. 1999; 37:824-830.
    • (1999) Med Care , vol.37 , pp. 824-830
    • Lamers, L.M.1
  • 8
    • 0035513625 scopus 로고    scopus 로고
    • Pharmacy-based risk adjustment for public programs
    • The Medicaid Rx Model
    • 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
  • 9
    • 0037264203 scopus 로고    scopus 로고
    • Risk adjustment using automated ambulatory pharmacy data: The RxRisk Model
    • Fishman PA, Goodman MJ, Hornbrook MC, et al. Risk adjustment using automated ambulatory pharmacy data: the RxRisk Model. Med Care. 2003;41:84-99.
    • (2003) Med Care , vol.41 , pp. 84-99
    • Fishman, P.A.1    Goodman, M.J.2    Hornbrook, M.C.3
  • 11
    • 0035722637 scopus 로고    scopus 로고
    • Health-based risk adjustment: Is inpatient and outpatient diagnostic information sufficient?
    • Lamers LM. Health-based risk adjustment: is inpatient and outpatient diagnostic information sufficient? Inquiry. 2001;38:423-431. (Pubitemid 34184705)
    • (2001) Inquiry , vol.38 , Issue.4 , pp. 423-431
    • Lamers, L.M.1
  • 12
    • 27744499759 scopus 로고    scopus 로고
    • Pharmacy- and diagnosis-based risk adjustment for children with medicaid
    • DOI 10.1097/01.mlr.0000182551.87591.73
    • Kuhlthau K, Ferris TG, Davis RB, et al. Pharmacy-and diagnosis-based risk adjustment for children with Medicaid. Med Care. 2005;43:1155-1159. (Pubitemid 41587603)
    • (2005) Medical Care , vol.43 , Issue.11 , pp. 1155-1159
    • Kuhlthau, K.1    Ferris, T.G.2    Davis, R.B.3    Perrin, J.M.4    Iezzoni, L.I.5
  • 13
    • 77951623340 scopus 로고    scopus 로고
    • Diagnostic, pharmacybased, and self-reported health measures in risk equalization models
    • Stam PJ, Van Vliet RCJA, Van de Ven WPMM. Diagnostic, pharmacybased, and self-reported health measures in risk equalization models. Med Care. 2010;48:448-457.
    • (2010) Med Care , vol.48 , pp. 448-457
    • Stam, P.J.1    Van Vliet, R.C.J.A.2    Van De Ven, W.P.M.M.3
  • 14
    • 0029737846 scopus 로고    scopus 로고
    • Chronic disease, functional health status, and demographics: A multi-dimensional approach to risk adjustment
    • Hornbrook MC, Goodman MJ. Chronic disease, functional health status, and demographics: a multi-dimensional approach to risk adjustment. Health Serv Res. 1996;31:283-307.
    • (1996) Health Serv Res , vol.31 , pp. 283-307
    • Hornbrook, M.C.1    Goodman, M.J.2
  • 15
    • 53649087097 scopus 로고    scopus 로고
    • Medicare capitation model, functional status and multiple comorbidities: Model accuracy
    • Noyes K, Hangsheng L, Temkin-Greener H. Medicare capitation model, functional status and multiple comorbidities: model accuracy. Am J Manag Care. 2008;14:679-690.
    • (2008) Am J Manag Care , vol.14 , pp. 679-690
    • Noyes, K.1    Hangsheng, L.2    Temkin-Greener, H.3
  • 17
    • 79953211154 scopus 로고    scopus 로고
    • Prior use of durable medical equipment as a risk adjuster for health-based capitation
    • Van Kleef RC, Van Vliet RCJA. Prior use of durable medical equipment as a risk adjuster for health-based capitation. Inquiry. 2010;47:343-358.
    • (2010) Inquiry , vol.47 , pp. 343-358
    • Van Kleef, R.C.1    Van Vliet, R.C.J.A.2
  • 18
    • 84856064166 scopus 로고    scopus 로고
    • Evaluatie risicoverevening tussen zorgverzekeraars (evalution risk equalization among health insurers)
    • Stam PJA, WPMM Van de Ven. Evaluatie risicoverevening tussen zorgverzekeraars (evalution risk equalization among health insurers). Tijdschrift voor Gezondheidswetenschappen. 2008;86:92-100.
    • (2008) Tijdschrift voor Gezondheidswetenschappen , vol.86 , pp. 92-100
    • Stam, P.J.A.1    Ven De Van, W.P.M.M.2
  • 19
    • 0001004715 scopus 로고
    • Predictability of individual health care expenditures
    • RCJA Van Vliet. Predictability of individual health care expenditures. J Risk Insurance. 1992;59:443-461.
    • (1992) J Risk Insurance , vol.59 , pp. 443-461
    • Van Vliet, R.C.J.A.1
  • 20
    • 0035121810 scopus 로고    scopus 로고
    • Risk sharing as a supplement to imperfect capitation: A tradeoff between selection and efficiency
    • DOI 10.1016/S0167-6296(00)00077-1, PII S0167629600000771
    • Van Barneveld EM, Lamers LM, Van Vliet RCJA, et al. Risk sharing as a supplement to imperfect capitation: a tradeoff between selection and efficiency. J Health Econ. 2001;20:147-168. (Pubitemid 32143701)
    • (2001) Journal of Health Economics , vol.20 , Issue.2 , pp. 147-168
    • Van Barneveld, E.M.1    Lamers, L.M.2    Van Vliet, R.C.J.A.3    Van De Ven, W.P.M.M.4
  • 22
    • 1442306512 scopus 로고    scopus 로고
    • Prior health expenditures and risk sharing with insurers competing on quality
    • Marchand M, Sato M, Schokkaert E. Prior health expenditures and risk sharing with insurers competing on quality. Rand J Econ. 2003;34:647-669. (Pubitemid 38284413)
    • (2003) RAND Journal of Economics , vol.34 , Issue.4 , pp. 647-669
    • Marchand, M.1    Sato, M.2    Schokkaert, E.3
  • 23
    • 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. (Pubitemid 24072707)
    • (1994) Health Affairs , vol.13 , Issue.1 , pp. 132-146
    • Newhouse, J.P.1


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.