The role of social, cognitive, and functional risk factors in Medicare spending for dual and nondual enrollees

KJ Johnston, KE Joynt Maddox - Health Affairs, 2019 - healthaffairs.org
The Centers for Medicare and Medicaid Services is increasingly focused on value-based
payment programs, which tie payment to performance on quality and cost measures. In this …

Neighborhood disadvantage and chronic disease management

SNM Durfey, AJH Kind, WR Buckingham… - Health services …, 2019 - Wiley Online Library
Objective To assess the relationship between a composite measure of neighborhood
disadvantage, the Area Deprivation Index (ADI), and control of blood pressure, diabetes …

Area deprivation and respiratory morbidities in children with bronchopulmonary dysplasia

E Banwell, JM Collaco, GR Oates, JL Rice… - Pediatric …, 2022 - Wiley Online Library
Introduction Infants and children diagnosed with bronchopulmonary dysplasia (BPD) have a
higher likelihood of recurrent hospitalizations and asthma‐like symptoms. Socio …

Incorporating machine learning and social determinants of health indicators into prospective risk adjustment for health plan payments

JA Irvin, AA Kondrich, M Ko, P Rajpurkar, B Haghgoo… - BMC Public Health, 2020 - Springer
Background Risk adjustment models are employed to prevent adverse selection, anticipate
budgetary reserve needs, and offer care management services to high-risk individuals. We …

A Framework for the Design of Risk-Adjustment Models in Health care Provider Payment Systems

A Panturu, R van Kleef, F Eijkenaar… - … Care Research and …, 2024 - journals.sagepub.com
Prospective payments for health care providers require adequate risk adjustment (RA) to
address systematic variation in patients' health care needs. However, the design of RA for …

Perspectives of Medicare Advantage plan representatives on addressing social determinants of health in response to the CHRONIC Care Act

KS Thomas, SNM Durfey, EA Gadbois… - JAMA network …, 2019 - jamanetwork.com
Importance The passage of the Creating High-Quality Results and Outcomes Necessary to
Improve Chronic (CHRONIC) Care Act in 2018 allows Medicare Advantage (MA) plans …

Racial and ethnic disparities in access to and enrollment in high‐quality Medicare Advantage plans

S Park, RM Werner, NB Coe - Health services research, 2023 - Wiley Online Library
Objective Racial and ethnic minority enrollees in Medicare Advantage (MA) plans tend to be
in lower‐quality plans, measured by a 5‐star quality rating system. We examine whether …

Neighborhood disadvantage and hospital quality ratings in the Medicare Hospital Compare Program

J Fahrenbach, MH Chin, ES Huang, MK Springman… - Medical care, 2020 - journals.lww.com
Background: The Centers for Medicare and Medicaid Services provide nationwide hospital
ratings that may influence reimbursement. These ratings do not account for the social risk of …

Incentivizing excellent care to at-risk groups with a health equity summary score

D Agniel, SC Martino, Q Burkhart… - Journal of General …, 2021 - Springer
Abstract Background Social risk factors (SRFs) such as minority race-and-ethnicity or low
income are associated with quality-of-care, health, and healthcare outcomes. Organizations …

The association of area deprivation and state child health with respiratory outcomes of pediatric patients with cystic fibrosis in the United States

G Oates, S Rutland, L Juarez, A Friedman… - Pediatric …, 2021 - Wiley Online Library
Background Differences in socioenvironmental exposures influence overall child health, but
their association with pediatric cystic fibrosis (CF) outcomes is less clear. This observational …