Using Encounter Data from Medicaid HMOs for Research and Monitoring
Complete encounter data from Medicaid HMOs are necessary to monitor patient access to care, compute risk-adjusted payments, and estimate savings from managed care. Encounter data from TennCare for 1996 and 1997 appear to be incomplete. This is the case despite state review of data quality, financial...
| Main Author: | |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2004-09-01
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| Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| Online Access: | https://doi.org/10.1177/004695800404100309 |
| _version_ | 1811324679069106176 |
|---|---|
| author | Merrile Sing |
| author_facet | Merrile Sing |
| author_sort | Merrile Sing |
| collection | DOAJ |
| description | Complete encounter data from Medicaid HMOs are necessary to monitor patient access to care, compute risk-adjusted payments, and estimate savings from managed care. Encounter data from TennCare for 1996 and 1997 appear to be incomplete. This is the case despite state review of data quality, financial sanctions for Medicaid HMOs that appeared to be submitting incomplete data, and a preliminary assessment of encounter data for samples of two Medicaid enrollee subgroups suggesting that the encounter data might be reasonably complete. Although all states are required to submit Medicaid encounter data to the government, most states currently produce incomplete encounter data. |
| first_indexed | 2024-04-13T14:19:49Z |
| format | Article |
| id | doaj.art-716a826b268d4647b46257143fb594f1 |
| institution | Directory Open Access Journal |
| issn | 0046-9580 1945-7243 |
| language | English |
| last_indexed | 2024-04-13T14:19:49Z |
| publishDate | 2004-09-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| spelling | doaj.art-716a826b268d4647b46257143fb594f12022-12-22T02:43:31ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432004-09-014110.1177/00469580040410030910.1177_004695800404100309Using Encounter Data from Medicaid HMOs for Research and MonitoringMerrile Sing0Agency for Healthcare Research and Quality.Complete encounter data from Medicaid HMOs are necessary to monitor patient access to care, compute risk-adjusted payments, and estimate savings from managed care. Encounter data from TennCare for 1996 and 1997 appear to be incomplete. This is the case despite state review of data quality, financial sanctions for Medicaid HMOs that appeared to be submitting incomplete data, and a preliminary assessment of encounter data for samples of two Medicaid enrollee subgroups suggesting that the encounter data might be reasonably complete. Although all states are required to submit Medicaid encounter data to the government, most states currently produce incomplete encounter data.https://doi.org/10.1177/004695800404100309 |
| spellingShingle | Merrile Sing Using Encounter Data from Medicaid HMOs for Research and Monitoring Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| title | Using Encounter Data from Medicaid HMOs for Research and Monitoring |
| title_full | Using Encounter Data from Medicaid HMOs for Research and Monitoring |
| title_fullStr | Using Encounter Data from Medicaid HMOs for Research and Monitoring |
| title_full_unstemmed | Using Encounter Data from Medicaid HMOs for Research and Monitoring |
| title_short | Using Encounter Data from Medicaid HMOs for Research and Monitoring |
| title_sort | using encounter data from medicaid hmos for research and monitoring |
| url | https://doi.org/10.1177/004695800404100309 |
| work_keys_str_mv | AT merrilesing usingencounterdatafrommedicaidhmosforresearchandmonitoring |