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Principal inpatient diagnostic cost group model for Medicare risk adjustment

dc.contributor.authorPope, Gregory C.
dc.contributor.authorEllis, Randall P.
dc.contributor.authorAsh, Arlene S.
dc.contributor.authorLiu, Chuan-Fen
dc.contributor.authorAyanian, John Z.
dc.contributor.authorBates, David W.
dc.contributor.authorBurstin, Helen
dc.contributor.authorIezzoni, Lisa I.
dc.contributor.authorIngber, Melvin J.
dc.date2022-08-11T08:10:42.000
dc.date.accessioned2022-08-23T17:17:09Z
dc.date.available2022-08-23T17:17:09Z
dc.date.issued2001-08-03
dc.date.submitted2010-07-01
dc.identifier.citationHealth Care Financ Rev. 2000 Spring;21(3):93-118. <a href="http://www.cms.gov/HealthCareFinancingReview/Downloads/00springpg93.pdf">Link to article on publisher's site</a>
dc.identifier.issn0195-8631 (Linking)
dc.identifier.pmid11481770
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47563
dc.description.abstractThe 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 contribute to higher costs, so that health plans can be paid more when they care for sicker patients. In this article, the authors describe the risk-adjustment model HCFA is implementing in the year 2000, known as the Principal Inpatient Diagnostic Cost Group (PIPDCG) model.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=11481770&dopt=Abstract">Link to Article in PubMed</a>
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectCapitation Fee
dc.subjectCenters for Medicare and Medicaid Services (U.S.)
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectDemography
dc.subjectDiagnosis-Related Groups
dc.subjectFemale
dc.subjectHumans
dc.subjectInfant
dc.subjectInfant, Newborn
dc.subjectMale
dc.subjectMedicaid
dc.subjectMedicare Part C
dc.subjectMiddle Aged
dc.subject*Models, Econometric
dc.subjectRisk Adjustment
dc.subjectUnited States
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titlePrincipal inpatient diagnostic cost group model for Medicare risk adjustment
dc.typeJournal Article
dc.source.journaltitleHealth care financing review
dc.source.volume21
dc.source.issue3
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1696&amp;context=qhs_pp&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/696
dc.identifier.contextkey1378842
refterms.dateFOA2022-08-23T17:17:10Z
html.description.abstract<p>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 contribute to higher costs, so that health plans can be paid more when they care for sicker patients. In this article, the authors describe the risk-adjustment model HCFA is implementing in the year 2000, known as the Principal Inpatient Diagnostic Cost Group (PIPDCG) model.</p>
dc.identifier.submissionpathqhs_pp/696
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages93-118


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