prescription drug utilization
Recently Published Documents


TOTAL DOCUMENTS

41
(FIVE YEARS 5)

H-INDEX

7
(FIVE YEARS 0)

2022 ◽  
Vol 5 (1) ◽  
pp. e2140371
Author(s):  
Peggah Khorrami ◽  
Michael S. Sinha ◽  
Aditi Bhanja ◽  
Heidi L. Allen ◽  
Aaron S. Kesselheim ◽  
...  

2019 ◽  
pp. 107755871987006
Author(s):  
Jianhui Xu ◽  
Erin Trish ◽  
Geoffrey Joyce

Beginning with the 2018 benefit year, the Centers for Medicare and Medicaid Services started incorporating select prescription drug utilization information into the Marketplace risk adjustment model. There has been little evidence about the impact of this change on payment accuracy and the mechanisms through which it may occur. Using commercial claims in 2017 from a large national health insurer, we find that the policy change improves payment accuracy in our sample and would help mitigate insurers’ selection incentives for some enrollees through two channels: imputing missing diagnoses and varying risk scores to better capture the heterogeneity in expenditures among patients with certain health conditions. However, while improving payment accuracy overall, there are potential perverse incentives that could distort treatment choice for marginal patients. Additionally, overcompensation and undercompensation persists for certain patient subgroups, suggesting an opportunity to further refine and improve the model.


2015 ◽  
Vol 25 (5) ◽  
pp. 606-619 ◽  
Author(s):  
Thierry Nianogo ◽  
Albert Okunade ◽  
Demba Fofana ◽  
Weiwei Chen

Sign in / Sign up

Export Citation Format

Share Document