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Identifying,
Assessing and Managing High-Risk Patients under Medicare Risk Contracts

Identifying, Assessing and Managing High-Risk Patients under Medicare Risk Contracts


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by Richard Dupee, M.D. and Ralph Halpern, M.S.W.
Physicians participating in Medicare managed care plans are increasingly sharing in the financial risks of providing care to enrollees. Although capitation payments are calculated to reflect the average costs for an entire patient panel, there is typically great variation among patients, from healthy individuals to patients requiring high volume and high-cost care.