HCFE Working Paper HCFE WP # 2003 - 02 VOLUNTARY PARTIAL CAPITATION : THE CNO MEDICARE DEMONSTRATION
نویسنده
چکیده
In a recently concluded Medicare demonstration, Community Nursing Organizations (CNOs) received capitated payment to provide a subset of Medicare services through a nursing case management delivery system. Demonstration participation was voluntary, both for CNOs and recruited beneficiaries, raising several challenging issues associated with selection. We investigate provider and beneficiary selection, as well as Medicare costs, using multiple evaluation methodologies. We find that CNO enrollment is associated with increased payment by Medicare for CNO-covered services. Results showing CNO enrollees to be more costly to Medicare for non-CNO services are consistent with cost-shifting, but could also be accounted for by biased provider selection into the demonstration. Austin B. Frakt and Steven D. Pizer are with the Boston University School of Public Health and the Department of Veterans Affairs. Robert J. Schmitz is with Mathematica Policy Research, Inc. Soeren Mattke is with RAND. Correspondence to: Austin B. Frakt, Center for Health Quality, Outcomes and Economic Research, 200 Springs Rd., Mail Stop 152, Bedford, MA 01730. Tel: (781) 687-3159. Email: [email protected] The work documented in this paper was conducted at Abt Associates, Inc. and supported by the Centers for Medicare & Medicaid Services (Contract No. 500-95-0062/T.O. 10).
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Voluntary Partial Capitation: The Community Nursing Organization Medicare Demonstration
In a recently concluded Medicare demonstration, Community Nursing Organizations (CNOs) received capitated payment to provide a subset of Medicare services through a nursing case management delivery system. Demonstration participation was voluntary, both for CNOs and recruited beneficiaries, raising several challenging issues associated with selection. We investigate provider and beneficiary sel...
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