title: Voluntary partial capitation: the Community Nursing Organization Medicare demonstration.
abstract: In a recently concluded Medicare demonstration, Community Nursing Organizations (CNOs) received capitated payment to provide a subset of Medicare services through a nursing case management delivery system. Demonstration participation was voluntary, both for CNOs and recruited beneficiaries, raising several challenging issues associated with selection. We investigate provider and beneficiary selection, as well as Medicare costs, using multiple evaluation methodologies. We find that CNO enrollment is associated with increased payment by Medicare for CNO-covered services. Results showing CNO enrollees to be more costly to Medicare for non-CNO services are consistent with cost shifting, but could also be accounted for by biased provider selection into the demonstration.
authors.affiliation: Boston University School of Public Health, USA. frakt@bu.edu
authors.forename: Austin B
authors.initials: AB
authors.lastname: Frakt
authors.forename: Steven D
authors.initials: SD
authors.lastname: Pizer
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Schmitz
authors.forename: Soeren
authors.initials: S
authors.lastname: Mattke
mesh_terms: D002204:Capitation Fee; D003152:Community Health Nursing / Q000458:organization & administration; D006801:Humans; D006278:Medicare / Q000191:economics*; D010865:Pilot Projects