2007PubMedOpen access

Diagnosis-based risk adjustment for medicare prescription drug plan payments.

John M. Robst, Jesse M. Levy, Melvin J. Ingber

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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.

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What this paper is about

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.

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OpenAlex reports 63 citations for this work. Citation counts describe recorded attention and do not establish research quality.

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Available 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.

Key concepts: Prescription drug, Medical prescription, Medicare Part D, Medicaid, Medicine, Medicare Advantage, Payment, Actuarial science

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