- Title
- Modeling Medicare costs of PACE populations
- First Author
- Robinson, James
- Date of Pub
- 2000 Spring
- Pages
- 149-170
- Volume
- 21
- Issue
- 3
- Other Authors
- Karon, Sarita L
- Abstract
- Historically, Medicare has paid PACE providers a monthly capitated rate equal to 95 percent of the site's county AAPCC multiplied by a PACE-specific frailty adjuster of 2.39. The Balanced Budget Act of 1997 makes PACE a permanent provider category and mandates that future Medicare payments be based upon the rate structure of the Medicare+Choice payment system, adjusted for the comparative frailty of PACE enrollees and other factors deemed to be appropriate by the Secretary of Health and Human Services. This study revisits the calculation of the PACE frailty adjuster and explores the effect of risk adjustment on that frailty adjuster.
- Abstract Continued
- N/A
- MeSH
- Frail Elderly : Health Expenditures : Insurance Selection Bias : Fee-for-Service Plans : Health Care Financing Administration : Health Maintenance Organizations : Medicaid : Medicare : Regression Analysis : Risk Factors : Support, U.S. Gov't, non-P.H.S. : United States
- NTIS Number
- N/A
