{"title":"Paying for Outcomes: Clinical Risk Groups-The Swiss Army Knife for Medicaid Programs.","authors":"Billy Millwee","doi":"10.1097/JAC.0000000000000448","DOIUrl":null,"url":null,"abstract":"CRGs are a clinically based categorical classification system that uses administrative data to identify children and adults with chronic health conditions. Claims and encounter records are used to group individuals into mutually exclusive, clinically based categories. These categories comprise specific conditions or combinations of conditions as well as the associated severity of those conditions or combinations of conditions. CRGs can also incorporate data from functional assessments and capture and use Z codes that offer insight into some characteristics of social determinants of health (SDOH).","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 2","pages":"83-85"},"PeriodicalIF":1.6000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JOURNAL OF AMBULATORY CARE MANAGEMENT","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/JAC.0000000000000448","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
CRGs are a clinically based categorical classification system that uses administrative data to identify children and adults with chronic health conditions. Claims and encounter records are used to group individuals into mutually exclusive, clinically based categories. These categories comprise specific conditions or combinations of conditions as well as the associated severity of those conditions or combinations of conditions. CRGs can also incorporate data from functional assessments and capture and use Z codes that offer insight into some characteristics of social determinants of health (SDOH).
期刊介绍：
The Journal of Ambulatory Care Management is a PEER-REVIEWED journal that provides timely, applied information on the most important developments and issues in ambulatory care management.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
