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Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model
This article describes the CMS hierarchical condition categories (HCC) model implemented in 2004 to adjust Medicare capitation payments to private health care plans for the health expenditure risk of their enrollees. We explain the model's principles, elements, organization, calibration, and pe...
| Autores principales: | , , , , , , , , |
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| Formato: | Online Artículo Texto |
| Lenguaje: | English |
| Publicado: |
CENTERS for MEDICARE & MEDICAID SERVICES
2004
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| Materias: | |
| Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194896/ https://www.ncbi.nlm.nih.gov/pubmed/15493448 |
| _version_ | 1782339210603134976 |
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| author | Pope, Gregory C. Kautter, John Ellis, Randall P. Ash, Arlene S. Ayanian, John Z. Iezzoni, Lisa I. Ingber, Melvin J. Levy, Jesse M. Robst, John |
| author_facet | Pope, Gregory C. Kautter, John Ellis, Randall P. Ash, Arlene S. Ayanian, John Z. Iezzoni, Lisa I. Ingber, Melvin J. Levy, Jesse M. Robst, John |
| author_sort | Pope, Gregory C. |
| collection | PubMed |
| description | This article describes the CMS hierarchical condition categories (HCC) model implemented in 2004 to adjust Medicare capitation payments to private health care plans for the health expenditure risk of their enrollees. We explain the model's principles, elements, organization, calibration, and performance. Modifications to reduce plan data reporting burden and adaptations for disabled, institutionalized, newly enrolled, and secondary-payer subpopulations are discussed. |
| format | Online Article Text |
| id | pubmed-4194896 |
| institution | National Center for Biotechnology Information |
| language | English |
| publishDate | 2004 |
| publisher | CENTERS for MEDICARE & MEDICAID SERVICES |
| record_format | MEDLINE/PubMed |
| spelling | pubmed-41948962014-11-04 Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model Pope, Gregory C. Kautter, John Ellis, Randall P. Ash, Arlene S. Ayanian, John Z. Iezzoni, Lisa I. Ingber, Melvin J. Levy, Jesse M. Robst, John Health Care Financ Rev Research Article This article describes the CMS hierarchical condition categories (HCC) model implemented in 2004 to adjust Medicare capitation payments to private health care plans for the health expenditure risk of their enrollees. We explain the model's principles, elements, organization, calibration, and performance. Modifications to reduce plan data reporting burden and adaptations for disabled, institutionalized, newly enrolled, and secondary-payer subpopulations are discussed. CENTERS for MEDICARE & MEDICAID SERVICES 2004 /pmc/articles/PMC4194896/ /pubmed/15493448 Text en |
| spellingShingle | Research Article Pope, Gregory C. Kautter, John Ellis, Randall P. Ash, Arlene S. Ayanian, John Z. Iezzoni, Lisa I. Ingber, Melvin J. Levy, Jesse M. Robst, John Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model |
| title | Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model |
| title_full | Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model |
| title_fullStr | Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model |
| title_full_unstemmed | Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model |
| title_short | Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model |
| title_sort | risk adjustment of medicare capitation payments using the cms-hcc model |
| topic | Research Article |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194896/ https://www.ncbi.nlm.nih.gov/pubmed/15493448 |
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