Improving Health-Based Payment for Medicaid Beneficiaries: CDPS

نویسندگان

  • Richard Kronick
  • Todd Gilmer
  • Tony Dreyfus
  • Lora Lee
چکیده

This article describes the Chronic Illness and Disability Payment System (CDPS), a diagnostic classification system that Medicaid programs can use to make health-based capitated payments for TANF and disabled Medicaid beneficiaries. The authors describe the diversity of diagnoses and different burdens of illness among disabled and AFDC Medicaid beneficiaries. Claims from seven States are analyzed, and payment weights are provided that States can use when adjusting HMO payments. The authors also compare the taxonomy and statistical performance of CDPS to other leading diagnostic classification systems and find that the new model performs better in a number of respects.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Effect of Medicare Advantage Payments on Dually Eligible Medicare Beneficiaries

This study estimates the effect of Medicare Advantage (MA) payments and State Medicaid policies on the choice by Medicaid eligible Medicare beneficiaries to either join a MA plan, remain in the fee-for-service (FFS) and enroll in Medicaid (dually enrolled), or remain in FFS Medicare without joining Medicaid. Individual plan choice was modeled using a multinomial logit. The sample includes Medic...

متن کامل

Hospital back-up days: Impact on joint Medicare and Medicaid beneficiaries

In this article the question of whether nursing home market characteristics affect the ability of hospitals to discharge patients to nursing homes is examined. Also examined is the question of whether joint Medicare and Medicaid beneficiaries have a more difficult time being placed than do other patients. The principal conclusions are first, that the nursing home bed supply and the type of Medi...

متن کامل

Research Issues: Dually Eligible Medicare and Medicaid Beneficiaries, Challenges and Opportunities

This overview describes the Medicare and Medicaid dually eligible beneficiaries, and it summarizes challenges in obtaining information and designing health care and supportive systems across the continuum of their needs. Some of the challenges include: the complexities of Medicaid eligibility, key structural differences between Medicare and Medicaid, long-standing data limitations, and determin...

متن کامل

Care Coordination for Dually Eligible Beneficiaries

Care coordination has been identified as a potential method of achieving the triple aim in health care—improving outcomes and care quality while reducing costs. Well-designed, targeted care coordination entails comprehensive coverage of services across a coordinated provider team working together to provide high-quality, patient-centered care. This model, however, faces significant challenges a...

متن کامل

Case Selection for a Medicaid Chronic Care Management Program

Medicaid agencies are beginning to turn to care management to reduce costs and improve health care quality. One challenge is selecting members at risk of costly, preventable service utilization. Using claims data from the State of Vermont, we compare the ability of three pre-existing health risk predictive models to predict the top 10 percent of members with chronic conditions: Chronic Illness ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 21  شماره 

صفحات  -

تاریخ انتشار 2000