Jove
Visualize
Contact Us

Related Experiment Videos

High ideals & perverse consequences: risk adjustments, encounter data & Medicare+Choice.

B M Fried1, P Freeman

  • 1Shaw Pittman Potts and Trowbridge, Washington, DC, USA.

Integrated Healthcare Report
|July 6, 1998
PubMed
Summary

Developing a Provider Sponsored Organization (PSO) involves significant risks. This article explores the complexities of government administration and risk adjustment for Medicare payments to PSOs and HMOs.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

'It's about collaboration': a whole-systems approach to understanding and promoting movement in Suffolk.

The international journal of behavioral nutrition and physical activity·2025
Same author

Bayesian clinical reasoning in the first opinion approach to a dog with suspected thoracolumbar pain.

The Journal of small animal practice·2022
Same author

Spontaneous resolution of severe disc-associated spinal cord compression in a dog.

The Journal of small animal practice·2022
Same author

Recurrence of signs consistent with cervical intervertebral disc extrusion in dogs.

The Journal of small animal practice·2022
Same author

Serum anti-GM2 and anti-GalNAc-GD1a IgG antibodies are biomarkers for acute canine polyradiculoneuritis.

The Journal of small animal practice·2021
Same author

A model of the UV skin dose distribution in paediatric whole-body phototherapy.

Physics in medicine and biology·2021
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Area of Science:

  • Health Policy
  • Healthcare Administration
  • Health Economics

Background:

  • Provider Sponsored Organizations (PSOs) face inherent risks and complications in their development.
  • The Centers for Medicare & Medicaid Services (CMS), formerly HCFA, administers programs impacting these organizations.
  • Trust in government program administration is a significant concern for healthcare organizations.

Purpose of the Study:

  • To examine the complexities and uncertainties surrounding the development and administration of PSOs.
  • To provide insight into the government's perspective on risk-adjusting Medicare payments for PSOs and HMOs.
  • To assess the potential risks and rewards for health systems engaging with government healthcare programs.

Main Methods:

  • Analysis of government program administration capabilities.

Related Experiment Videos

  • Exploration of risk-adjustment methodologies for Medicare payments.
  • Qualitative assessment of organizational trust in government healthcare initiatives.

    • Main Results:

    • Developing PSOs presents multifaceted risks beyond organizational capabilities, including governmental administrative capacity.
    • Governmental trust and program follow-through are critical, yet often uncertain, factors for PSOs and HMOs.
    • Risk-adjustment mechanisms aim to increase payments for providers caring for sicker senior populations.

    Conclusions:

    • The decision to develop a PSO requires a thorough understanding of governmental program administration and risk.
    • Uncertainty in government execution and trust significantly impacts PSO viability.
    • Risk-adjusted Medicare payments offer potential financial benefits for managing high-need patient populations.