Developing A Risk Adjustment Methodology for Medicare Drug Plans

09/01/2005

This paper describes the work NORC did to supplement the Federal Employee Health Benefits data (FEHBP) used to develop drug risk adjustment factors for over 65 individuals with a full drug supplement to Medicare. This data needed to be supplemented because the FEHBP data did not adequately represent, low-income, disabled, or non east Coast populations. After linking Medicaid data to Medicare data to get the appropriate drug diagnoses, the utilization patterns of low-income and disabled populations was examined. The higher utilization found was used to develop special payment adjustments for drug plans which enrolled such individuals. [PDF - 4 pages]

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