Adjusting capitation rates using objective health measures and prior utilization.
Newhouse, Joseph P
Date of Pub
Keeler, Emmett B; Manning Jr, Willard G; Sloss, Elizabeth M
Several analysts have proposed adding adjusters based on health status and prior utilization to the adjusted average per capita
cost formula. The authors estimate how well such adjusters predict annual medical expenditures among non-elderly adults. Both
measures substantially improve on the variables currently used. If only health measures are added, 20-30 percent of the predictable
variance is explained; if only prior use is added, more than 40 percent is explained; if both are added, about 60 percent
is explained. The results support including some measure of use in the formula until better health measures are developed.
Health : Health Status : Actuarial Analysis : Aged : Capitation Fee/standards : Data Collection : Demography : Fees and Charges/standards
: Health Expenditures/statistics & numerical data : Health Maintenance Organizations/utilization : Human : Medicare/utilization
: Models, Statistical : Probability : Support, Non-U.S. Gov't : Support, U.S. Gov't, Non-P.H.S. : United States