Capitation Adjustment for Children with Special Health Care Needs
有特殊医疗保健需求的儿童的按人头调整
基本信息
- 批准号:7373919
- 负责人:
- 金额:$ 28.04万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2007
- 资助国家:美国
- 起止时间:2007-09-30 至 2009-09-29
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
Although risk-adjusted capitation payments have commonly been implemented by public and
private insurers, few risk adjustment models have been estimated specifically for children.
Increasing reliance on cost containment mechanisms, such as managed care and capitation in
both private markets and public programs targeting children, makes the need to set adequate
capitation rates for children more urgent. This study addresses this need by developing risk
adjustment models for children, especially children with special health care needs (CSHCN),
who are particularly vulnerable in the current health insurance marketplace dominated by
managed care plans. The goal of the proposed project is to inform policy-making on three
important issues of health care financing for children: (1). How well can risk adjustment models
estimated specifically for children perform? (2). How much are health plans? incentives for risk
selection reduced under different risk adjustment models for children? and (3). How much can a
mixed system of both risk-adjusted capitation and risk-sharing (i.e. reinsurance funded by the
sponsor) reduce selection incentives?
This study has four specific aims:
Specific Aim 1: To assess the persistence of high expenditures among CSHCN and the
persistence of CSHCN status.
Specific Aim 2: First to estimate a risk adjustment model using information about CSHCN, and
then to assess its predictive performance through comparison with the diagnosis-based models.
Specific Aim 3: To simulate health plans? potential profits from risk selection under different risk
adjusters.
Specific Aim 4: To investigate health plans? potential profit under the mixed system that has both
risk-adjusted capitation rates and risk-sharing. Two types of risk-sharing will be examined,
including outliers risk-sharing for high-cost children and condition-specific risk-sharing.
This study fits in the Agency of Healthcare Research and Quality's (AHRQ) priority program
area of "Identifying Strategies to Improve Access, Foster Appropriate Use, and Reduce
Unnecessary Expenditures." In particular, it will use the AHRQ's Medical Expenditure Panel
Survey (MEPS) to assess how changes in financial arrangements affect access to care by
CSHCN, a vulnerable population of special interest to the AHRQ.
尽管经风险调整的资本支付通常由公共和私营部门实施
项目成果
期刊论文数量(0)
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