在估计老年慢性病患者人数时要保守。

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引用次数: 0

摘要

本月小贴士:注意选择索赔数据的方式。一位顾问指出,医疗服务提供者使用过去的医疗保险索赔数据来确定哪些成员患有慢性病,以及他们可能需要花费多少钱,这可能会因为选择标准不明确而做出不准确的估计。
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Be conservative when sizing up chronically ill senior population.

Tip of the Month: Watch how you select claims data. A consultant points out that providers using past Medicare claims data to determine which members have chronic conditions and how much they are likely to cost can make inaccurate estimates by using unfocused selection criteria.

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Reach out to community to develop culturally sensitive patient care. CA study finds some challenges in Medicaid may be universal. Troubled PHO reveals Medicare risk contracting strategy. Model for PCP contracts offers right incentives for Medicare, Medicaid providers. Collect data, monitor claims receipts to ensure prompt Medicare, Medicaid payment.
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