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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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| Published in: | Health care financing review 2003-01, Vol.24 (4), p.31-43 |
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| Main Authors: | , , , , , , , |
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| container_end_page | 43 |
| container_issue | 4 |
| container_start_page | 31 |
| container_title | Health care financing review |
| container_volume | 24 |
| creator | Shapiro, Jennifer R Dykstra, Dawn M Pisoni, Ron Beronja, Nancy Gaylin, Daniel S Oppenheimer, Caitlin Carroll Rubin, Robert J Held, Philip J |
| description | 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. |
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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.</description><identifier>ISSN: 0195-8631</identifier><identifier>EISSN: 1554-9887</identifier><identifier>PMID: 14628398</identifier><language>eng</language><publisher>United States: Superintendent of Documents</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Beneficiaries ; California ; Capitation ; Centers for Medicare and Medicaid Services, U.S ; Chronic illnesses ; Comorbidity ; Comparative analysis ; Data collection ; Enrollments ; Fee-for-Service Plans - economics ; Fee-for-Service Plans - statistics & numerical data ; Female ; Florida ; Health maintenance organizations ; Health Maintenance Organizations - economics ; Health Maintenance Organizations - statistics & numerical data ; Hemodialysis ; HMOs ; Humans ; Insurance Selection Bias ; Kidney Failure, Chronic - economics ; Kidney Failure, Chronic - therapy ; Kidneys ; Male ; Medical records ; Medicare ; Medicare - legislation & jurisprudence ; Middle Aged ; Nephrology ; Patient satisfaction ; Patient Selection ; Patients ; Peritoneal dialysis ; Pilot Projects ; Primary care ; Quality of life ; Renal Dialysis - economics ; Socioeconomic Factors ; Studies ; Transplants & implants ; United States</subject><ispartof>Health care financing review, 2003-01, Vol.24 (4), p.31-43</ispartof><rights>COPYRIGHT 2003 Superintendent of Documents</rights><rights>Copyright Superintendent of Documents Summer 2003</rights><rights>2003</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/196945898/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/196945898?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,11667,21373,33588,33589,36037,36038,43709,44339,53766,53768,73964,74638</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14628398$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shapiro, Jennifer R</creatorcontrib><creatorcontrib>Dykstra, Dawn M</creatorcontrib><creatorcontrib>Pisoni, Ron</creatorcontrib><creatorcontrib>Beronja, Nancy</creatorcontrib><creatorcontrib>Gaylin, Daniel S</creatorcontrib><creatorcontrib>Oppenheimer, Caitlin Carroll</creatorcontrib><creatorcontrib>Rubin, Robert J</creatorcontrib><creatorcontrib>Held, Philip J</creatorcontrib><title>Patient selection in the ESRD managed care demonstration</title><title>Health care financing review</title><addtitle>Health Care Financ Rev</addtitle><description>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.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Beneficiaries</subject><subject>California</subject><subject>Capitation</subject><subject>Centers for Medicare and Medicaid Services, U.S</subject><subject>Chronic illnesses</subject><subject>Comorbidity</subject><subject>Comparative analysis</subject><subject>Data collection</subject><subject>Enrollments</subject><subject>Fee-for-Service Plans - economics</subject><subject>Fee-for-Service Plans - statistics & numerical data</subject><subject>Female</subject><subject>Florida</subject><subject>Health maintenance organizations</subject><subject>Health Maintenance Organizations - economics</subject><subject>Health Maintenance Organizations - statistics & numerical data</subject><subject>Hemodialysis</subject><subject>HMOs</subject><subject>Humans</subject><subject>Insurance Selection Bias</subject><subject>Kidney Failure, Chronic - economics</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Kidneys</subject><subject>Male</subject><subject>Medical records</subject><subject>Medicare</subject><subject>Medicare - legislation & jurisprudence</subject><subject>Middle Aged</subject><subject>Nephrology</subject><subject>Patient satisfaction</subject><subject>Patient Selection</subject><subject>Patients</subject><subject>Peritoneal dialysis</subject><subject>Pilot Projects</subject><subject>Primary care</subject><subject>Quality of life</subject><subject>Renal Dialysis - economics</subject><subject>Socioeconomic Factors</subject><subject>Studies</subject><subject>Transplants & implants</subject><subject>United States</subject><issn>0195-8631</issn><issn>1554-9887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>M0C</sourceid><sourceid>M2R</sourceid><recordid>eNptkV1LwzAUhosobk7_ghQvvKs0TZqe3Ahjzg8YKH5chyw97TLaZDad4L83Y1NUxrk4kDx53_PmHERDkucsEQDFYTRMicgT4JQMohPvl2lKspSK42hAGM-AChhG8KR6g7aPPTaoe-NsbGzcLzCevjzfxK2yqsYy1qrDuMTWWd93aoOdRkeVajye7fooerudvk7uk9nj3cNkPEtqynmf6DJVIi8KpllGKSBJKwa8qrQuQwEvC83nHAnVcyaUygBK1Dko1LykNFV0FF1vdVfreYulDrN2qpGrzrSq-5ROGfn3xpqFrN2HZEQwIFkQuNwJdO59jb6XrfEam0ZZdGsvC0IFzUAE8OIfuHTrzoZwkgguWA4CApRsoVo1KI2tXDDVNVoM3s5iZcLxmKSCc8Zg4361hw8VPtPovQ_Of-f9Cfq9MvoFlOiTdg</recordid><startdate>20030101</startdate><enddate>20030101</enddate><creator>Shapiro, Jennifer R</creator><creator>Dykstra, Dawn M</creator><creator>Pisoni, Ron</creator><creator>Beronja, Nancy</creator><creator>Gaylin, Daniel S</creator><creator>Oppenheimer, Caitlin Carroll</creator><creator>Rubin, Robert J</creator><creator>Held, Philip J</creator><general>Superintendent of Documents</general><general>CENTERS for MEDICARE & MEDICAID SERVICES</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>0-V</scope><scope>0U~</scope><scope>1-H</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7WY</scope><scope>7WZ</scope><scope>7X7</scope><scope>7XB</scope><scope>87Z</scope><scope>88C</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FL</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BEZIV</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FRNLG</scope><scope>FYUFA</scope><scope>F~G</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K60</scope><scope>K6~</scope><scope>K9.</scope><scope>KB0</scope><scope>L.-</scope><scope>L.0</scope><scope>M0C</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M2R</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PADUT</scope><scope>PQBIZ</scope><scope>PQBZA</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PYYUZ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20030101</creationdate><title>Patient selection in the ESRD managed care demonstration</title><author>Shapiro, Jennifer R ; Dykstra, Dawn M ; Pisoni, Ron ; Beronja, Nancy ; Gaylin, Daniel S ; Oppenheimer, Caitlin Carroll ; Rubin, Robert J ; Held, Philip J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g366t-cd0a95774c42338e10f486ffccdcdc86d7c6b6e13cb49aa288dec58aec6d330a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Beneficiaries</topic><topic>California</topic><topic>Capitation</topic><topic>Centers for Medicare and Medicaid Services, U.S</topic><topic>Chronic illnesses</topic><topic>Comorbidity</topic><topic>Comparative analysis</topic><topic>Data collection</topic><topic>Enrollments</topic><topic>Fee-for-Service Plans - 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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.</abstract><cop>United States</cop><pub>Superintendent of Documents</pub><pmid>14628398</pmid><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-8631 |
| ispartof | Health care financing review, 2003-01, Vol.24 (4), p.31-43 |
| issn | 0195-8631 1554-9887 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4194812 |
| source | EBSCOhost Business Source Ultimate; Social Science Premium Collection; ABI/INFORM Global; PubMed Central |
| subjects | Adult Aged Aged, 80 and over Beneficiaries California Capitation Centers for Medicare and Medicaid Services, U.S Chronic illnesses Comorbidity Comparative analysis Data collection Enrollments Fee-for-Service Plans - economics Fee-for-Service Plans - statistics & numerical data Female Florida Health maintenance organizations Health Maintenance Organizations - economics Health Maintenance Organizations - statistics & numerical data Hemodialysis HMOs Humans Insurance Selection Bias Kidney Failure, Chronic - economics Kidney Failure, Chronic - therapy Kidneys Male Medical records Medicare Medicare - legislation & jurisprudence Middle Aged Nephrology Patient satisfaction Patient Selection Patients Peritoneal dialysis Pilot Projects Primary care Quality of life Renal Dialysis - economics Socioeconomic Factors Studies Transplants & implants United States |
| title | Patient selection in the ESRD managed care demonstration |
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