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Comorbidity-Based Payment Methodology for Medicaid Enrollees with HIV/AIDS
Managed care organizations (MCOs) may be incurring financial losses from persons with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) (PWHA). This study developed a statistical model to examine which specific comorbidities are important contributors to the variations...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
CENTERS for MEDICARE & MEDICAID SERVICES
2001
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194718/ https://www.ncbi.nlm.nih.gov/pubmed/12500338 |
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author | Fakhraei, S. Hamid Kaelin, John J. Conviser, Richard |
author_facet | Fakhraei, S. Hamid Kaelin, John J. Conviser, Richard |
author_sort | Fakhraei, S. Hamid |
collection | PubMed |
description | Managed care organizations (MCOs) may be incurring financial losses from persons with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) (PWHA). This study developed a statistical model to examine which specific comorbidities are important contributors to the variations in health care costs of PWHA. Individuals were classified into cost groups to simulate biased selection in MCOs. Capitation payments for various cost groups under different methodologies were compared. The statistical model closely matched payments with the actual costs of care. Capitation payments for HIV/AIDS enrollees based on this model will better protect MCOs than the traditional risk-adjustment methods. |
format | Online Article Text |
id | pubmed-4194718 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2001 |
publisher | CENTERS for MEDICARE & MEDICAID SERVICES |
record_format | MEDLINE/PubMed |
spelling | pubmed-41947182014-11-04 Comorbidity-Based Payment Methodology for Medicaid Enrollees with HIV/AIDS Fakhraei, S. Hamid Kaelin, John J. Conviser, Richard Health Care Financ Rev Research Article Managed care organizations (MCOs) may be incurring financial losses from persons with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) (PWHA). This study developed a statistical model to examine which specific comorbidities are important contributors to the variations in health care costs of PWHA. Individuals were classified into cost groups to simulate biased selection in MCOs. Capitation payments for various cost groups under different methodologies were compared. The statistical model closely matched payments with the actual costs of care. Capitation payments for HIV/AIDS enrollees based on this model will better protect MCOs than the traditional risk-adjustment methods. CENTERS for MEDICARE & MEDICAID SERVICES 2001 /pmc/articles/PMC4194718/ /pubmed/12500338 Text en |
spellingShingle | Research Article Fakhraei, S. Hamid Kaelin, John J. Conviser, Richard Comorbidity-Based Payment Methodology for Medicaid Enrollees with HIV/AIDS |
title | Comorbidity-Based Payment Methodology for Medicaid Enrollees with HIV/AIDS |
title_full | Comorbidity-Based Payment Methodology for Medicaid Enrollees with HIV/AIDS |
title_fullStr | Comorbidity-Based Payment Methodology for Medicaid Enrollees with HIV/AIDS |
title_full_unstemmed | Comorbidity-Based Payment Methodology for Medicaid Enrollees with HIV/AIDS |
title_short | Comorbidity-Based Payment Methodology for Medicaid Enrollees with HIV/AIDS |
title_sort | comorbidity-based payment methodology for medicaid enrollees with hiv/aids |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194718/ https://www.ncbi.nlm.nih.gov/pubmed/12500338 |
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