Actuarial methods for improving HCFA payments to risk HMOs
Subtitle: appendices to final report, April 12, 1996
By: authors: C. William Wrightson, et. al
Contributors: Actuarial Research Corporation; United States. Health Care Financing Administration
Publisher: Actuarial Research Corporation
Published: 1996
Place of publication: Annandale, VA
Language: eng
Subjects: Medicare; Health maintenance organizations; Estimates; Costs; Mathematical models
Description: "Four alternative payment methods were tested as alternatives to the Adjusted Average Per Capita Cost (AAPCC) : reinsurance, select and ultimate rates, partial capitation and blended rates, and experience rating. using data from the Continuous Medicare History Sample (CMHS) and from one HMO, the study concluded that there are a range of methods than can improve payment to HMOs. Specifically, partial capitation and blended rates were effective in limiting the financial risk incurred by plans. Reinsurance models protected against catastrophic costs incurred by plans while the rate adjustments used in select and ultimate rates can mitigate against severe selection effects. Finally, experience rating did not accurately predict future costs for Medicare beneficiaries. However, each method used in this study represented improvements over the current AAPCC."-- NTIS report documentation page.
Notes: Final report ; 1996.

Available at cost as a print-on-demand technical report ; National Technical Information Service ; PB97-126841.

Photocopy. Springfield, VA. : Dept. of Commerce, National Technical Information Service, [1996]. 28 cm.

Prepared for: Department of Health & Human Services, Health Care Financing Administration ; Cooperative agreement no. 17-C-90033/3.
Table of contents: title: Appendix A. Development of thresholds for outlier pools in 1995 alternative payment demonstration / prepared for Health Care Financing   Administration, Actuarial Research Corporation... September 1994; title: Appendix B. [Re: Analysis of the cost of reinsurance options for the medicare choices demonstration, September 12, 1995; title: Appendix C. Experience-rated questionnaire for 1996 rates.