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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.
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主题 | Aging |
URL | https://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. |
条目包含的文件 | ||||||
文件名称/大小 | 资源类型 | 版本类型 | 开放类型 | 使用许可 | ||
410582-The-Direct-Pa(154KB) | 智库出版物 | 限制开放 | CC BY-NC-SA | 浏览 |
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