Limits...
Medicare risk adjustment for the frail elderly.

Kautter J, Ingber M, Pope GC - Health Care Financ Rev (2008)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: RTI International, Waltham, MA 02451, USA. jkautter@rti.org

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.

Show MeSH
Medicare Fee-for-Service Home Health Expenditures, by Activities of Daily Living (ADLs), 1994-2002
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4195052&req=5

f2-hcfr-30-02-083: Medicare Fee-for-Service Home Health Expenditures, by Activities of Daily Living (ADLs), 1994-2002

Mentions: To illustrate, Figure 2 tracks Medicare FFS per capita home health expenditures by ADL group between 1994 and 2002. As is evident in the figure, there is a significant drop in home health expenditures for the high ADL group during the late 1990s. Given the frailty adjustment model predicts residual expenditures (actual expenditures minus CMS-HCC predicted expenditures), to the extent that high ADL beneficiaries' actual expenditures were decreased by the change in the home health payment system, this would have lowered their residual expenditures, and hence their frailty factor.


Medicare risk adjustment for the frail elderly.

Kautter J, Ingber M, Pope GC - Health Care Financ Rev (2008)

Medicare Fee-for-Service Home Health Expenditures, by Activities of Daily Living (ADLs), 1994-2002
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4195052&req=5

f2-hcfr-30-02-083: Medicare Fee-for-Service Home Health Expenditures, by Activities of Daily Living (ADLs), 1994-2002
Mentions: To illustrate, Figure 2 tracks Medicare FFS per capita home health expenditures by ADL group between 1994 and 2002. As is evident in the figure, there is a significant drop in home health expenditures for the high ADL group during the late 1990s. Given the frailty adjustment model predicts residual expenditures (actual expenditures minus CMS-HCC predicted expenditures), to the extent that high ADL beneficiaries' actual expenditures were decreased by the change in the home health payment system, this would have lowered their residual expenditures, and hence their frailty factor.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: RTI International, Waltham, MA 02451, USA. jkautter@rti.org

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.

Show MeSH