Diagnosis-based risk adjustment for medicare prescription drug plan payments

Melvin J. Ingber; John Michael. Robst; John Robst; JM Levy; Melvin J. Ingber

Diagnosis-based risk adjustment for medicare prescription drug plan payments

Robst, J., Levy, JM., & Ingber, M. (2007). Diagnosis-based risk adjustment for medicare prescription drug plan payments. Health Care Financing Review, 28(4), 15-30. http://www.cms.hhs.gov/HealthCareFinancingReview/downloads/07Summerpg15.pdf

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Abstract

The 2003 Medicare Prescription Drug, Improvement, and Modernization Act (MMA) created Medicare Part D, a voluntary prescription drug benefit program. The benefit is a government subsidized prescription drug benefit within Medicare. This article focuses on the development of the prescription drug risk-adjustment model used to adjust payments to reflect the health status of plan enrollees