Medicare risk adjustment for the frail elderly.

Health Care Financing Review Pub Date : 2008-01-01
John Kautter, Melvin Ingber, Gregory C Pope
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Abstract

CMS has had a continuing interest in exploring ways to incorporate frailty adjustment into the CMS Hierarchical Condition Categories (CMS-HCC) risk adjustment methodology for Medicare Advantage and other Medicare private organizations. In this article we present research results for Medicare risk adjustment of the frail elderly since the adoption of frailty adjustment for Program of All-Inclusive Care for the Elderly (PACE) organizations in 2004. In particular, we present results on the revised frailty adjuster that is being phased in for PACE organizations between 2008 and 2012.

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老年人体弱多病的医疗保险风险调整。
CMS一直有兴趣探索将虚弱调整纳入CMS分层条件类别(CMS- hcc)风险调整方法的方法,用于医疗保险优势和其他医疗保险私人组织。本文介绍了自2004年“全包式老年照护计划”(PACE)机构采用虚弱调整以来,对体弱老年人医疗保险风险调整的研究结果。特别是,我们介绍了修订后的脆弱性调整器的结果,该调整器将在2008年至2012年期间逐步用于PACE组织。
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Health Care Financing Review
Health Care Financing Review 医学-卫生保健
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