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Patient selection in the ESRD managed care demonstration

The Centers for Medicare & Medicaid Service's (CMS') end stage renal disease (ESRD) managed care demonstration offered an opportunity to assess patient selection among a chronically ill and inherently costly population. Patient selection refers to the phenomenon whereby those Medicare...

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Bibliographic Details
Published in:Health care financing review 2003-01, Vol.24 (4), p.31-43
Main Authors: Shapiro, Jennifer R, Dykstra, Dawn M, Pisoni, Ron, Beronja, Nancy, Gaylin, Daniel S, Oppenheimer, Caitlin Carroll, Rubin, Robert J, Held, Philip J
Format: Article
Language:English
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Summary:The Centers for Medicare & Medicaid Service's (CMS') end stage renal disease (ESRD) managed care demonstration offered an opportunity to assess patient selection among a chronically ill and inherently costly population. Patient selection refers to the phenomenon whereby those Medicare beneficiaries who choose to enroll or stay in health maintenance organizations (HMOs) are, on average, younger, healthier, and less costly to treat than beneficiaries who remain in the traditional Medicare fee-for-service (FFS) sector. The results presented in this article show that enrollees into the demonstration were generally younger and healthier than a representative group of comparison patients from the same geographic areas.
ISSN:0195-8631
1554-9887