Medicare's risk-adjusted capitation method.
Since 1997, the method to establish capitation rates for Medicare beneficiaries who are members of risk-bearing managed care plans has undergone several important developments. This includes the factoring of beneficiary health status into the rate-setting calculations. These changes were expected to increase the number of participating health plans, accelerate Medicare enrollment growth, and slice Medicare spending.
Grimaldi
Paul L
PL
State Healthcare Division of Affiliated Computer Services, Inc., Rockville, MD, USA.
D000368:Aged; D002204:Capitation Fee; D014487:Centers for Medicare and Medicaid Services, U.S.; D003361:Cost Allocation; D003953:Diagnosis-Related Groups / Q000145:classification* / Q000191:economics*; D006233:Persons with Disabilities; D018588:Fee-for-Service Plans / Q000191:economics / Q000592:standards; D006801:Humans; D007297:Inpatients / Q000145:classification; D008329:Managed Care Programs / Q000191:economics* / Q000592:standards; D016344:Medicare Part A / Q000191:economics* / Q000331:legislation & jurisprudence; D016345:Medicare Part B / Q000191:economics* / Q000331:legislation & jurisprudence; D020398:Medicare Part C / Q000191:economics* / Q000331:legislation & jurisprudence; D011785:Quality Assurance, Health Care; D011907:Rate Setting and Review; D020379:Risk Adjustment; D020414:Risk Sharing, Financial; D014481:United States