دورية أكاديمية

Distributing $800 billion: an early assessment of Medicare Part D risk adjustment.

التفاصيل البيبلوغرافية
العنوان: Distributing $800 billion: an early assessment of Medicare Part D risk adjustment.
المؤلفون: Hsu J (AUTHOR), Huang J (AUTHOR), Fung V (AUTHOR), Price M (AUTHOR), Brand R (AUTHOR), Hui R (AUTHOR), Fireman B (AUTHOR), Dow W (AUTHOR), Bertko J (AUTHOR), Newhouse JP (AUTHOR)
المصدر: Health Affairs. Jan/Feb2009, Vol. 28 Issue 1, p215-225. 11p.
مستخلص: The viability and stability of the Medicare Part D prescription drug program depend on accurate risk-adjusted payments. The current approach, prescription drug hierarchical condition categories (RxHCCs), uses diagnosis and demographic information to predict future drug costs. We evaluated the performance of multiple approaches for predicting 2006 Part D drug costs and plan liability. RxHCCs explain 12 percent of the variation in actual drug costs, overpredict costs for beneficiaries with low actual costs, and underpredict costs for beneficiaries with high actual costs. Combining RxHCCs with individual-level information on prior-year drug use greatly improves performance and decreases incentives for plans to select against bad risks. [ABSTRACT FROM AUTHOR]
Copyright of Health Affairs is the property of Project HOPE/HEALTH AFFAIRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
قاعدة البيانات: Business Source Index
الوصف
تدمد:02782715
DOI:10.1377/hlthaff.28.1.215