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Titolo:
Discretionary hospital use and diagnostic risk adjustment of Medicare HMO capitation rates
Autore:
Porell, FW; Gruenberg, L;
Indirizzi:
Univ Massachusetts, Inst Gerontol, Boston, MA 02125 USA Univ Massachusetts Boston MA USA 02125 nst Gerontol, Boston, MA 02125 USA
Titolo Testata:
INQUIRY-THE JOURNAL OF HEALTH CARE ORGANIZATION PROVISION AND FINANCING
fascicolo: 2, volume: 37, anno: 2000,
pagine: 162 - 172
SICI:
0046-9580(200022)37:2<162:DHUADR>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
16
Recensione:
Indirizzi per estratti:
Indirizzo: Porell, FW Univ Massachusetts, Inst Gerontol, 100 Morrissey Blvd, Boston, MA 02125 USA Univ Massachusetts 100 Morrissey Blvd Boston MA USA 02125 5 USA
Citazione:
F.W. Porell e L. Gruenberg, "Discretionary hospital use and diagnostic risk adjustment of Medicare HMO capitation rates", INQUIRY-J H, 37(2), 2000, pp. 162-172

Abstract

The health maintenance organization (HMO) industry has expressed concern that implementation of a diagnostic risk adjustment model based solely on diagnoses from inpatient hospitalizations will penalize Medicare HMOs that have been successful in controlling costs by reducing discretionary hospitalizations. This study compares the diagnostic composition of HMO and fee-for-service (FFS) hospitalizations in four states to test the proposition that lower Medicare HMO hospital admission rates are the result of lower rates of "high-discretion" hospitalizations. The empirical findings show very little difference in the proportion of Medicare HMO and FFS hospitalizations with principal diagnoses rated as high discretion, and do not suggest that Medicare HMOs have been more successful in reducing discretionary hospitalizations than nondiscretionary ones.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 03:14:01