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Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model

This article describes the CMS hierarchical condition categories (HCC) model implemented in 2004 to adjust Medicare capitation payments to private health care plans for the health expenditure risk of their enrollees. We explain the model's principles, elements, organization, calibration, and pe...

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Main Authors: Pope, Gregory C., Kautter, John, Ellis, Randall P., Ash, Arlene S., Ayanian, John Z., Iezzoni, Lisa I., Ingber, Melvin J., Levy, Jesse M., Robst, John
Format: Artigo
Sprog:Inglês
Udgivet: CENTERS for MEDICARE & MEDICAID SERVICES 2004
Fag:
Online adgang:https://ncbi.nlm.nih.gov/pmc/articles/PMC4194896/
https://ncbi.nlm.nih.gov/pubmed/15493448
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