Adjusting Risk Adjustment — Accounting for Variation in Diagnostic Intensity
In the U.S. health care system, payments and performance measures are often adjusted to account for differences in patients’ baseline health and demographic characteristics. The idea behind such risk adjustments is to create a level playing field, so that providers aren’t penalized for serving sicke...
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| Format: | Article |
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New England Journal of Medicine
2018
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| Online Access: | http://hdl.handle.net/1721.1/114281 https://orcid.org/0000-0002-9941-6684 https://orcid.org/0000-0003-3910-1573 https://orcid.org/0000-0003-4364-1505 |
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| author | Gentzkow, Matthew Finkelstein, Amy Hull, Peter Davenport Williams, Heidi L |
| author2 | Massachusetts Institute of Technology. Department of Economics |
| author_facet | Massachusetts Institute of Technology. Department of Economics Gentzkow, Matthew Finkelstein, Amy Hull, Peter Davenport Williams, Heidi L |
| author_sort | Gentzkow, Matthew |
| collection | MIT |
| description | In the U.S. health care system, payments and performance measures are often adjusted to account for differences in patients’ baseline health and demographic characteristics. The idea behind such risk adjustments is to create a level playing field, so that providers aren’t penalized for serving sicker or harder-to-treat patients and insurers aren’t penalized for covering them. For example, the private insurance companies that participate in Medicare Advantage and the Affordable Care Act (ACA) exchanges receive risk-adjusted payments from the U.S. government, with the rationale that insurers should be reimbursed more for enrollees with higher expected costs. |
| first_indexed | 2024-09-23T17:02:06Z |
| format | Article |
| id | mit-1721.1/114281 |
| institution | Massachusetts Institute of Technology |
| last_indexed | 2024-09-23T17:02:06Z |
| publishDate | 2018 |
| publisher | New England Journal of Medicine |
| record_format | dspace |
| spelling | mit-1721.1/1142812022-09-29T23:12:03Z Adjusting Risk Adjustment — Accounting for Variation in Diagnostic Intensity Gentzkow, Matthew Finkelstein, Amy Hull, Peter Davenport Williams, Heidi L Massachusetts Institute of Technology. Department of Economics Finkelstein, Amy Hull, Peter Davenport Williams, Heidi L In the U.S. health care system, payments and performance measures are often adjusted to account for differences in patients’ baseline health and demographic characteristics. The idea behind such risk adjustments is to create a level playing field, so that providers aren’t penalized for serving sicker or harder-to-treat patients and insurers aren’t penalized for covering them. For example, the private insurance companies that participate in Medicare Advantage and the Affordable Care Act (ACA) exchanges receive risk-adjusted payments from the U.S. government, with the rationale that insurers should be reimbursed more for enrollees with higher expected costs. 2018-03-23T22:28:41Z 2018-03-23T22:28:41Z 2017-02 2018-02-21T18:35:44Z Article http://purl.org/eprint/type/JournalArticle 0028-4793 1533-4406 http://hdl.handle.net/1721.1/114281 Finkelstein, Amy, Matthew Gentzkow, Peter Hull, and Heidi Williams. “Adjusting Risk Adjustment — Accounting for Variation in Diagnostic Intensity.” New England Journal of Medicine 376, no. 7 (February 16, 2017): 608–610. © 2017 Massachusetts Medical Society https://orcid.org/0000-0002-9941-6684 https://orcid.org/0000-0003-3910-1573 https://orcid.org/0000-0003-4364-1505 http://dx.doi.org/10.1056/NEJMP1613238 New England Journal of Medicine Article is made available in accordance with the publisher's policy and may be subject to US copyright law. Please refer to the publisher's site for terms of use. application/pdf New England Journal of Medicine The New England Journal of Medicine |
| spellingShingle | Gentzkow, Matthew Finkelstein, Amy Hull, Peter Davenport Williams, Heidi L Adjusting Risk Adjustment — Accounting for Variation in Diagnostic Intensity |
| title | Adjusting Risk Adjustment — Accounting for Variation in Diagnostic Intensity |
| title_full | Adjusting Risk Adjustment — Accounting for Variation in Diagnostic Intensity |
| title_fullStr | Adjusting Risk Adjustment — Accounting for Variation in Diagnostic Intensity |
| title_full_unstemmed | Adjusting Risk Adjustment — Accounting for Variation in Diagnostic Intensity |
| title_short | Adjusting Risk Adjustment — Accounting for Variation in Diagnostic Intensity |
| title_sort | adjusting risk adjustment accounting for variation in diagnostic intensity |
| url | http://hdl.handle.net/1721.1/114281 https://orcid.org/0000-0002-9941-6684 https://orcid.org/0000-0003-3910-1573 https://orcid.org/0000-0003-4364-1505 |
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