Arlene S. Ash

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Risk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model

Gregory C. Pope, John Kautter, +6 authors John M Robst
Health care financing review
2004

This article describes the CMS hierarchical condition categories (HCC) model implemented in 2004 to adjust Medicare capitation payments to private health care plans for the health expenditure risk of… (More)

Adjusting Medicare capitation payments using prior hospitalization data

Arlene S. Ash, Frank W. Porell, Leonard Gruenberg, Eric Sawitz, Alexa Beiser
Health care financing review
1989

The diagnostic cost group approach to a reimbursement model for health maintenance organizations is presented. Diagnostic information about previous hospitalizations is used to create empirically… (More)

Using Diagnoses to Describe Populations and Predict Costs

Arlene S. Ash, Randall P. Ellis, +6 authors Wei Yu
Health care financing review
2000

The Diagnostic Cost Group Hierarchical Condition Category (DCG/HCC) payment models summarize the health care problems and predict the future health care costs of populations. These models use the… (More)

Predicting pharmacy costs and other medical costs using diagnoses and drug claims.

Yang Zhao, Arlene S. Ash, +4 authors Lori Weyuker
Medical care
2005

BACKGROUND Predicting health care costs for individuals and populations is essential for managing care. However, the comparative power of diagnostic and drug data for predicting future costs has not… (More)

Finding future high-cost cases: comparing prior cost versus diagnosis-based methods.

Arlene S. Ash, Yingxu Zhao, Randall P. Ellis, M Schlein Kramer
Health services research
2001

OBJECTIVE To examine the value of two kinds of patient-level dat a (cost and diagnoses) for identifying a very small subgroup of a general population with high future costs that may be mitigated with… (More)

Relation of family responsibilities and gender to the productivity and career satisfaction of medical faculty.

Phyllis L. Carr, Arlene S. Ash, +5 authors Mark A. Moskowitz
Annals of internal medicine
1998

BACKGROUND Studies have found that female faculty publish less, have slower career progress, and generally have a more difficult time in academic careers than male faculty. The relation of family… (More)

Quality improvement implementation in the nursing home.

Dan R Berlowitz, Gary J. Young, +8 authors Mark A. Moskowitz
Health services research
2003

OBJECTIVE To examine quality improvement (QI) implementation in nursing homes, its association with organizational culture, and its effects on pressure ulcer care. DATA SOURCES/STUDY SETTING… (More)

Chemotherapy use among Medicare beneficiaries at the end of life.

Ezekiel J. Emanuel, Yinong Young-Xu, Norman G. Levinsky, Gail Gazelle, Olga Saynina, Arlene S. Ash
Annals of internal medicine
2003

BACKGROUND Although many observers believe that cancer chemotherapy is overused at the end of life, there are no published data on this. OBJECTIVE To determine the frequency and duration of… (More)

Principal Inpatient Diagnostic Cost Group Model for Medicare Risk Adjustment

Gregory C. Pope, Randall P. Ellis, +6 authors Melvin J. Ingber
Health care financing review
2000

The Balanced Budget Act (BBA) of 1997 required HCFA to implement health-status-based risk adjustment for Medicare capitation payments for managed care plans by January 1, 2000. In support of this… (More)

Diagnosis-Based Risk Adjustment for Medicare Capitation Payments

Randall P. Ellis, Gregory C. Pope, +4 authors Arlene S. Ash
Health care financing review
1996

Using 1991-92 data for a 5-percent Medicare sample, we develop, estimate, and evaluate risk-adjustment models that utilize diagnostic information from both inpatient and ambulatory claims to adjust… (More)

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