Principal inpatient diagnostic cost group model for Medicare risk adjustment.

作者：Gregory C. Pope, Randall P. Ellis, Arlene S. Ash, Chuan‐Fa Liu, John Z. Ayanian, David Westfall Bates, Helen R. Burstin, Lisa I. Iezzoni, Melvin J. Ingber · 发表于：PubMed · 年份：2000 · 被引用次数：217 · 研究领域：Healthcare Policy and Management、Primary Care and Health Outcomes、Health Systems, Economic Evaluations, Quality of Life

The Balanced Budget Act (BBA) of 1997 required HCFA to implement health-status-based risk adjustment for Medicare capitation payments for managed care plans by January 1, 2000. In support of this mandate, HCFA has been collecting inpatient encounter data from health plans since 1997. These data include diagnoses and other information that can be used to identify chronic medical problems that contribute to higher costs, so that health plans can be paid more when they care for sicker patients. In this article, the authors describe the risk-adjustment model HCFA is implementing in the year 2000, known as the Principal Inpatient Diagnostic Cost Group (PIPDCG) model.