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Journal Article
J Health Polit Policy Law (2005) 30 (3): 453–474.
Published: 01 June 2005
...David Blumenthal; Joel S. Weissman; Melissa Wachterman; Evette Weil; Randall S. Stafford; James M. Perrin; Timothy G. Ferris; Karen Kuhlthau; Rainu Kaushal; Lisa I. Iezzoni Risk adjustment (RA) consists of a series of techniques that account for the health status of patients when predicting...
View articletitled, The Who, What, and Why of <span class="search-highlight">Risk</span> <span class="search-highlight">Adjustment</span>: A Technology on the Cusp of Adoption
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for article titled, The Who, What, and Why of <span class="search-highlight">Risk</span> <span class="search-highlight">Adjustment</span>: A Technology on the Cusp of Adoption
Journal Article
J Health Polit Policy Law (2005) 30 (3): 475–504.
Published: 01 June 2005
...Joel S. Weissman; Melissa Wachterman; David Blumenthal Health-based risk adjustment has long been touted as key to the success of competitive models of health care. Because it decreases the incentive to enroll only healthy patients in insurance plans, risk adjustment was incorporated into Medicare...
View articletitled, When Methods Meet Politics: How <span class="search-highlight">Risk</span> <span class="search-highlight">Adjustment</span> Became Part of Medicare Managed Care
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for article titled, When Methods Meet Politics: How <span class="search-highlight">Risk</span> <span class="search-highlight">Adjustment</span> Became Part of Medicare Managed Care
Journal Article
J Health Polit Policy Law (2018) 43 (3): 401–425.
Published: 01 June 2018
... as an example of the role evidence plays in policy deliberations. The report addressed the question of whether Medicare's value-based purchasing programs should be adjusted for patients' social risk factors. Despite high-quality and consistent results about the relationship between performance and social risk...
FIGURES
View articletitled, Should Medicare's Value-Based Pricing Be <span class="search-highlight">Adjusted</span> for Social <span class="search-highlight">Risk</span> Factors? The Role of Research Evidence in Policy Deliberations
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for article titled, Should Medicare's Value-Based Pricing Be <span class="search-highlight">Adjusted</span> for Social <span class="search-highlight">Risk</span> Factors? The Role of Research Evidence in Policy Deliberations
Journal Article
J Health Polit Policy Law (2023) 48 (6): 919–950.
Published: 01 December 2023
... to insurers are adjusted for quality performance. The authors analyze the statute underlying these three design features and explore legislative and regulatory strategies for improving Medicare Advantage. They conclude that regulatory approaches for improving risk adjustment and for recouping overpayments...
Journal Article
J Health Polit Policy Law (1995) 20 (3): 615–652.
Published: 01 June 1995
... in slowing the reform by frustrating the development of a prospective, risk-adjusted payment mechanism. The resistance of corporatist organizations to the 1974 and 1987 reforms provoked a largely unplanned process of creeping etati-zation. Paradoxically, the present market-oriented reforms coincide with far...
Journal Article
J Health Polit Policy Law (2015) 40 (1): 245–255.
Published: 01 February 2015
... managed care, they have differences that have been deliberately designed to improve care coordination, increase accountability, and incorporate greater community governance. Reforms include global budgets integrating medical, behavioral, and oral health care and public health functions; risk-adjusted...
FIGURES
Journal Article
J Health Polit Policy Law (2010) 35 (1): 95–126.
Published: 01 February 2010
... and Hofler 2001; Li and Rosenman 2001; McKay, Deily,
and Dorner 2002/3). Therefore, we included risk-adjusted rates of in-
hospital mortality for congestive heart failure (CHF), in-hospital mor-
tality for pneumonia, iatrogenic pneumothorax, infection due to medi-
cal care, and accidental puncture...
Journal Article
J Health Polit Policy Law (2004) 29 (6): 1187–1226.
Published: 01 December 2004
...: Kaiser Family Foundation and Health Research and Educational Trust. Keenan, P. S., M. J. B. Buntin, T. G. McGuire, and J. P. Newhouse. 2001 . The Prevalence of Formal Risk Adjustment in Health Plan Purchasing. Inquiry 38 : 245 -259. Luft, H. S. 1995 . Potential Methods to Reduce Risk Selection...
Journal Article
J Health Polit Policy Law (2000) 25 (5): 875–887.
Published: 01 October 2000
..., Market Power, and Monopsony. Health Services Research 33 (5): 1439 -1460. Schokkaert, E., and C. van de Voorde. 2000 . Risk Adjustment and the Fear of Markets: The Case of Belgium. Health Care Management Science 3 : 121 -130. Schokkaert, E., G. Dhaene, and C. van de Voorde. 1998 . Risk...
Journal Article
J Health Polit Policy Law (2005) 30 (3): 315–326.
Published: 01 June 2005
... that is pretty much guaranteed to leave a sour taste in
policy makers’ mouths?) In each case, the authors describe an aspect of
health policy—ranging from the technical details of risk adjustment to
America’s emerging collective panic about medical errors—that is center
stage in contemporary health...
Journal Article
J Health Polit Policy Law (2020) 45 (5): 801–816.
Published: 01 October 2020
..., the “risk corridor” program provided supplemental funding to plans with costs 3% greater than a target amount, funded largely by assessments on firms with costs 3% lower than expected. Second, the “risk adjustment” program transferred funds from insurers with a high proportion of low-risk enrollees to ones...
Journal Article
J Health Polit Policy Law (2000) 25 (5): 937–944.
Published: 01 October 2000
... strong incentives for risk selection,
which is prohibited by the LHI. As a countermeasure, a risk-adjustment
scheme was introduced in 1993. But the risk-adjustment formula contains
only age and sex as predictors of future HCE. Such a formula is known to
have very low predictive power (van de Ven...
Journal Article
J Health Polit Policy Law (1998) 23 (6): 995–1003.
Published: 01 December 1998
...Regina E. Herzlinger; Jacob S. Hacker Copyright © 1998 by Duke University Press 1998 References Alpha Center. Health-Based Payments: What Do We Know about Risk Adjustment? 1998. Paper given at the Robert Wood Johnson Conference, Arlington, VA, 29 January. References Blendon...
Journal Article
J Health Polit Policy Law (2000) 25 (1): 71–100.
Published: 01 February 2000
... also use pure community rating within each of
these market segments. Pure community rating allows no rate adjustment
for age, gender, health status, occupation, group size, or other risk-based
factors. Adjustments are allowed only for location, family size...
Journal Article
J Health Polit Policy Law (1999) 24 (5): 1230–1237.
Published: 01 October 1999
... of competitive health care reform, “risk adjustment,”
emerges center stage. This time, however, it surfaces with more real-
world experience and short-term significance attached to it, since some
states and large employers have already tried to implement risk adjust-
ment and the BBA requires that Medicare...
Journal Article
J Health Polit Policy Law 11825354.
Published: 28 February 2025
... Advantage. Finally, the article highlights potential ways to fix Medicare s problems and promote its sustainability for future generations. Keywords Medicare, Medicare Advantage, payment reform, risk adjustment, health care spending Medicare was enacted in 1965 and began enrolling beneficiaries in 1966...
Journal Article
J Health Polit Policy Law (2002) 27 (3): 495–512.
Published: 01 June 2002
... in payment rates among
urban and rural areas and addressing evidence of selection bias
through risk adjustment;
(b) part of an effort to extend the life of the Medicare trust fund by reduc-
ing Medicare payments to fee-for-service providers and managed
care...
Journal Article
J Health Polit Policy Law (2005) 30 (1-2): 189–210.
Published: 01 April 2005
... University Press. Lamers, L. M., R. C. J. A. van Vliet, and W. P. M. M. van de Ven. 2003 . Risk Adjusted Premium Subsidies and Risk Sharing: Key Elements of the Competitive Sickness Fund Market in the Netherlands. Health Policy 65 : 49 -62. Lieverdink, H. 2001 . The Marginal Success of Regulated...
Journal Article
J Health Polit Policy Law (2002) 27 (1): 37–48.
Published: 01 February 2002
... risk adjustment of premiums so that delivery systems
that attract a disproportionate share of patients with predictably higher
costs are not penalized. Without risk adjustment, there are incentives to
avoid enrollment of chronically ill people and therefore to avoid excel-
lence in treating them...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 911–921.
Published: 01 August 2015
.... A procedure for “risk adjustment” must be established so that insurers who enroll a higher-than-average proportion of high-medical-cost patients do not experience severe financial losses as a consequence. Consider the ACA's reliance on state governments as well as the federal government. Medicare for All...
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