Risk adjustment wrinkle.
Health plans and providers contracting under Medicare risk want greater equity and the right incentives. Clinical risk adjustment, already being tried in various forms on the private health insurance side, seems to offer a good solution. But the tremendous lack of outpatient data for risk adjustment is throwing up a very big obstacle to the evolution of the Medicare+Choice program, and could result in bad public policy, some industry observers warn. Is the federal government about to make a policy misstep at a critical moment in the Medicare program's development?
D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D014487:Centers for Medicare and Medicaid Services, U.S.; D003284:Contract Services; D006760:Hospitalization / Q000191:economics; D015273:Insurance Selection Bias; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D020398:Medicare Part C / Q000191:economics / Q000706:statistics & numerical data*; D011050:Policy Making; D016730:Program Development; D012051:Reimbursement Mechanisms; D020379:Risk Adjustment; D020414:Risk Sharing, Financial; D014481:United States