Toward risk adjustment in mental health in Israel: calculation of risk adjustment rates from large outpatient and inpatient databases
نویسندگان
چکیده
منابع مشابه
Risk adjustment for high utilizers of public mental health care.
BACKGROUND: Publicly funded mental health systems are increasingly implementing managed care systems, such as capitation, to control costs. Capitated contracts may increase the risk for disenrollment or adverse outcomes among high cost clients with severe mental illness. Risk-adjusted payments to providers are likely to reduce providers' incentives to avoid or under-treat these people. However,...
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Synopsis: Risk selection, which occurs when an individual’s demand for a product is correlated with her risk, creates inefficiencies and inequalities in markets for those products and services. Studies have shown that risk selection often occurs in health care markets, especially in markets for health insurance. Risk adjustment is a method that has been developed to correct those inefficiencies...
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The Balanced Budget Act (BBA) of 1997 required HCFA to implement health-status-based risk adjustment for Medicare capitation payments for managed care plans by January 1, 2000. In support of this mandate, HCFA has been collecting inpatient encounter data from health plans since 1997. These data include diagnoses and other information that can be used to identify chronic medical problems that co...
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ژورنال
عنوان ژورنال: Israel Journal of Health Policy Research
سال: 2020
ISSN: 2045-4015
DOI: 10.1186/s13584-020-00373-6