G2TT
来源类型Research Report
规范类型报告
The Direct Payment Method for Medicare Managed Care Plans
其他题名A Concept Paper
Jack Hadley; Marilyn Moon; Stephanie Maxwell; Stephen Zuckerman
发表日期2002-08-01
出版年2002
语种英语
概述This concept paper extends and develops an idea for an alternative methodology Medicare might use to determine capitation payments to health plans that participate in the Medicare+Choice program. The Direct Payment Method, first suggested by Greenwald et al. (1998), would shift the basis of payment away from the current approach, which builds on county-based Medicare fee-for-service (FFS) expenditures, to a
摘要
This concept paper extends and develops an idea for an alternative methodology Medicare might use to determine capitation payments to health plans that participate in the Medicare+Choice program. The Direct Payment Method, first suggested by Greenwald et al. (1998), would shift the basis of payment away from the current approach, which builds on county-based Medicare fee-for-service (FFS) expenditures, to a national model that predicts expenditures for individual Medicare enrollees. Ideally, the Direct Payment Method would use detailed encounter data for Medicare+Choice enrollees, information on the cost of the services they received, and a health-based risk adjuster to predict expenditures for individual enrollees. When combined with geographic adjustments for input prices and local market conditions, the resulting payment would be independent of the extreme and highly problematic geographic variations in Medicare's FFS payments per enrollee.
主题Aging
URLhttps://www.urban.org/research/publication/direct-payment-method-medicare-managed-care-plans
来源智库Urban Institute (United States)
资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/474545
推荐引用方式
GB/T 7714
Jack Hadley,Marilyn Moon,Stephanie Maxwell,et al. The Direct Payment Method for Medicare Managed Care Plans. 2002.
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文件名: 410582-The-Direct-Payment-Method-for-Medicare-Managed-Care-Plans.pdf
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