*  Medicaid risk adjustment model with diagnosis and pharmacy-based adjusters
66Newhouse, J. P. (1986). Rate adjusters for Medicare under capitation. Health Care Financing Review Annual Supplement, 8, 45-56. Newhouse, J. P. and others (1989). Adjusting capitation rates using objective health measures and prior utilization. Health Care Financing Review, 10(3), 41-54. Pacala, J.T., Boult, C., Urdangarin, C., and McCaffrey, D. (2003). Using self-reported data to predict expenditures for the health care of older people. Journal of the American Geriatrics Society, 51(5), 609-614. Pope, G.C., Ellis, R.P, Ash, A.S., and others (2000). Principal inpatient diagnostic cost group models for Medicare risk adjustment. Health Care Financing Review, 21(3), 93-118. Putnam, K.G., Buist, D.S.M., Fishman, P., Andrade, S.E., Boles, M., Chase, G.A., Goodman, M.J., Gurwitz, J.H., Platt, R., Raebel, M.A., and Chan, K.A. (2002). Chronic disease score as a predictor of subsequent hospitalization: a multiple HMO study. Epidemiology, 13, 340-344. Riley, G.F. (2000). ...
*  Hybrid risk adjustment for pharmaceutical benefits
Downloadable! This paper analyses the application of hybrid risk adjustment versus either prospective or concurrent risk adjustment formulae in the context of funding pharmaceutical benefits for the population of an integrated healthcare delivery organization in Catalonia during years 2002 and 2003. We apply a mixed formula and find that a hybrid risk adjustment model increases incentives for efficiency in the provision of low risk individuals at health organizations not only as a whole but also at each internal department compared to only prospective models by reducing within-group variation of drug expenditures.
*  Final payment notice for Medicare Advantage and Part D both good news and disappointing - ACHP
202-251-8881 (cell). For immediate release April 4, 2016:. Today's announcement of the Final Payment Notice for Medicare Advantage and Part D is a mixture of good news and disappointing news. ACHP is pleased that capitation rates will increase by just over 3 percent for 2017, although with other changes, the increase for the average county will be 0.85 percent. We welcome the transitional year that CMS has provided for the change in the bidding process for employer group waiver plans.. The adoption of a revised risk adjustment model provides welcome benefit for Special Needs Plans (SNP) caring for low-income and disabled individuals and other plans with high enrollment of dually eligible Medicare and Medicaid beneficiaries. We are disappointed that CMS did not reflect concerns, however, about the impact of this change on other MA plans.. We appreciate that CMS has slowed down transition to using encounter data for calculating risk scores, to allow time for ...
*  "Developing a diagnosis-based severity classification system for use in" by Evaline A. Alessandrini, Elizabeth R. Alpern et al.
Alessandrini, E. A., Alpern, E. R., Chamberlain, J. M., Shea, J. A., Holubkov, R., & Gorelick, M. H. (2012). Developing a diagnosis-based severity classification system for use in emergency medical services for children. Academic Emergency Medicine, 19(1), 70-78.. ...
This page contains the abstract A Theoretical Model For The Development Of A Diagnosis-based Clinical Decision Rule For The Management Of Patients With Spinal Pain http://www.chiro.org/LINKS/ABSTRACTS/A_Theoretical_Model_For_The_Development.shtml
20. A camera module, comprising: a lens unit configured to take in light from an object and focus an object image; an image sensor configured to capture the object image; and an image processing apparatus configured to perform a process of an image signal acquired by capturing in the image sensor, wherein the image processing apparatus includes: a white balance adjustment unit configured to perform a white balance adjustment by multiplication of a white balance gain, on an image signal; a first color judgment gate generation unit configured to generate a first color judgment gate that defines an entire range of a color temperature subject to the white balance adjustment; a second color judgment gate generation unit configured to generate a second color judgment gate that defines the range of the color temperature subject to the white balance adjustment for each light source identified according to the white balance gain; and a color judgment ...
*  Taking health status into account when setting capitation rates : A comparison of risk-adjustment methods. | Base documentaire ...
Objective. - To compare performance of different health status measures for risk-adjusting capitation rates. Design. - Cross-sectional study. Health status measures derived from 1 year were used to predict resources for that year and the next. Setting. - Group-network health maintenance organization in Minnesota. Participants. - Sample of 18-to...
*  Risk adjustment performance of Charlson and Elixhauser comorbidities in ICD-9 and ICD-10 administrative databases | BMC Health...
We compared the performance of the Charlson and the Elixhauser comorbidity measures in predicting short and long term mortality among patients with CHF, diabetes, CRF, stroke, and CABG between ICD-9 and ICD-10 Canadian hospital discharge abstract databases. We found that most comorbidities studied had similar frequencies across ICD-9 and ICD-10 databases although variations were observed for some comorbidities. The performance of the Charlson and Elixhauser comorbidity measures in discriminating mortality was similar in ICD-9 data as well as ICD-10 data across five study cohorts.. In the patients with CHF and stroke, the C-statistic values for the predicting in-hospital or 1 year mortality were notably low with values of 0.63 and 0.66 for CHF and 0.62 and 0.67 for stroke, respectively. The low values might reflect the fact that some powerful clinical predictors of poor outcomes were not included in these measures due to a lack of information in the administrative databases, such as ejection ...
*  AMA Store: Risk Adjustment Documentation & Coding
Risk adjustment practices consider chronic diseases as predictors of future healthcare needs and expenses. Detailed documentation and compliant diagnosis coding are critical for proper risk adjustment. Buy this today|
*  Do Hierarchical Condition Category Model Scores Predict Hospitalization Risk in Newly Enrolled Medicare Advantage Participants...
To compare how well hierarchical condition categories (HCC) and probability of repeated admission (PRA) scores predict hospitalization. Longitudinal cohort study with 12-month follow-up. A Medicare Advantage (MA) plan. Four thousand five hundred six newly enrolled beneficiaries. HCC scores were...
*  risk-adjustment for patient characteristics for survey
Hi, Does anyone have any experience conducting surveys. For some surveys in order to ensure sample characteristics is representative of population, people use post-stratification weighting. Can we also use risk-adjustment or case-mix modeling afterwards to make sure hospitals are comparable? Should we be only using one or the other? Thank you.
*  Unison modular flex guide rail adjustment system from Tronics
The Unison modular flex guide rail adjustment system is designed to reduce the amount of time spent changing guide rails on conveyor systems.
*  Part II. Introduction to Measures of Quality (continued) | Agency for Healthcare Research & Quality
The major limitation of risk adjustment is that it can only account for measurable and reported risk factors. Unfortunately, many important risk factors for adverse patient outcomes are either not measurable using available data (e.g., preoperative functional status) or are not consistently reported (e.g., obesity). For some outcome measures, such as heart attack mortality at the hospital level, classification of hospital performance is reasonably robust despite these immeasurable or unreported factors, because between-hospital variation in outcomes is relatively large.87,88 In addition, unmeasured risk factors tend to be randomly distributed across hospitals.89 For other outcome measures, the limitations of risk adjustment are likely to be more problematic, particularly at the physician level, due to clustering of certain types of patients in certain physicians' practices.. Another problem ...
*  Find the Perfect Healthcare Job - Hueman Risk Adjustment Staffing
Let Hueman Risk Adjustment Staffing help find you a fulfilling career with a healthcare job providing home-health assessments with flexible hours.
*  Risk Adjustment Coder for United Health | Work At Home Gigs
The Job -- Risk Adjustment Coder for United Health Location -- Full telecommute, available anywhere. Job Responsibilities -- From Monster.com
*  Diagnosis Questions- Risk Adjustment validation
I am doing a RADV audit for patients for DOS in 2006. A high level definition of the RADV audit is Risk Adjustment data Validation, that requires us (
*  Clients - Risk Adjustment Staffing Solutions - Hueman
Our risk adjustment staffing solutions make providing care to your members easier by hiring the best healthcare providers available.
*  Learn About Our Risk Adjustment Staffing Company - Hueman
At Hueman Risk Adjustment Staffing, we have differentiated ourselves in the industry by creating a world-class culture unique to us.
*  Census of Population and Housing, 1990 [United States]: Public Law (P.L.) 94-171 Data (One-Half Sample Adjusted Redistricting...
Data Collection Notes: (1) Census tracts and block groups are not included in these files. (2) These data files were obtained from the United States House of Representatives, who received them from the Census Bureau accompanied by the following caveats: "The numbers contained herein are not official 1990 decennial Census counts. The numbers represent estimates of the population based on a statistical adjustment method applied to the official 1990 Census figures using a sample survey intended to measure overcount or undercount in the Census results. On July 15, 1991, the Secretary of Commerce decided not to adjust the official 1990 decennial Census counts (see 56 Fed. Reg. 33582, July 22, 1991). In reaching his decision, the Secretary determined that there was not sufficient evidence that the adjustment method accurately distributed the population across and within states. The numbers contained in these tapes, which had to be produced prior to the Secretary's decision, are ...
*  Injury Severity Scoring and Outcomes Research | Trauma, 8e | AccessSurgery | McGraw-Hill Medical
The injury scores and models discussed here are generally applied using retrospectively collected data. They are therefore suitable for case mix adjustment or risk prediction in groups of patients but are not appropriate for individual patient predictions to guide clinical management decisions. They have a host of applications including quality improvements in patient care, trauma systems and health care delivery, injury prevention initiatives, and epidemiological studies of injury. Patient-specific clinical prediction applications are more simple, requiring decision rules to categorize patients into low-risk/high-risk "bins" and present less sophisticated statistical demand. ...
*  CMS Proposes Fixes to ACA Marketplace Risk Adjustment
Sept. 2-New standards proposed for the government-run health insurance marketplace reflect how the Centers for Medicare & Medicaid Services (CMS) is
*  Dynamic Healthcare Systems to Attend RISE Risk Adjustment conference on November 10-11, 2016 in Miami,FL
Irvine, Ca (PRWEB) October 18, 2016 -- Dynamic Healthcare Systems, a leading provider of enterprise-wide solutions to health plans participating in Medicare
*  Generalized Modeling Approaches to Risk Adjustment of Skewed Outcomes Data
Downloadable! There are two broad classes of models used to address the econometric problems caused by skewness in data commonly encountered in health care applications: (1) transformation to deal with skewness (e.g., OLS on ln(y)); and (2) alternative weighting approaches based on exponential conditional models (ECM) and generalized linear model (GLM) approaches. In this paper, we encompass these two classes of models using the three parameter generalized gamma (GGM) distribution, which includes several of the standard alternatives as special cases - OLS with a normal error, OLS for the log normal, the standard gamma and exponential with a log link, and the Weibull. Using simulation methods, we find the tests of identifying distributions to be robust. The GGM also provides a potentially more robust alternative estimator to the standard alternatives. An example using inpatient expenditures is also analyzed.
*  Some Northern California Station Plots « Climate Audit
I've plotted up some USHCN station information for the 18 sites closest to Susanville (why Susanville - it's one of the Anthony Watts- Russ Steele sites that they happened to post on lately.) I've been reading Karl and Williams 1987 which sort of describes the USHCN Station History Adjustment method. I'll talk about Karl and…
*  HCC University: January 2014
All topics of discussion must be based on factual information, for example: Coding rules or guidelines, changes to the model (proposed and finalized),inclusion or exclusion of diagnosis codes in the CMS-HCC or Rx-HCC model, discussion of the annual Advance notice, discussion of the annual Announcement provisions, CMS posted rules related to coding or Risk Adjustment, general questions about medical records, mentions of a specific solution that are integral to the comment (e.g., we use blank report from Ascender to determine _______) which do not constitute an endorsement of the product; Recommendations of other CMS or other tools which are available at no charge to the public (e.g, the American Academy of Family Practice has a good general physical exam template. It can be downloaded at ...