TITLE

Voluntary Partial Capitation: The Community Nursing Organization Medicare Demonstration

AUTHOR(S)
Frakt, Austin B.; Pizer, Steven D.; Schmitz, Robert J.; Mattke, Soeren
PUB. DATE
June 2005
SOURCE
Health Care Financing Review;Summer2005, Vol. 26 Issue 4, p21
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
In a recently concluded Medicare demonstration, Community Nursing Organizations (CNOs) received capitated payment to provide a subset of Medicare services through a nursing case management delivery system. Demonstration participation was voluntary, both for CNOs and recruited beneficiaries, raising several challenging issues associated with selection. We investigate provider and beneficiary selection, as well as Medicare costs, using multiple evaluation methodologies. We find that CNO enrollment is associated with increased payment by Medicare for CNO-covered services. Results showing CNO enrollees to be more costly to Medicare for non-CNO services are consistent with cost shifting, but could also be accounted for by biased provider selection into the demonstration.
ACCESSION #
18314262

 

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