Studies from University of Pennsylvania Add New Findings in the Area of Pulmonary Disease (Hierarchical Condition Categories for Pulmonary Diseases Population Health Management and Policy Opportunities)

2019 MAY 02 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Current study results on Pulmonary Disease have been published. According to news reporting originating in Philadelphia, Pennsylvania, by NewsRx editors, the research stated, “Hierarchical condition categories (HCCs) are groups of diagnostic codes that are used to adjust federal payments to insurers and health systems based on differences in expected spending. Risk models built on HCCs improve on previous adjustment strategies that used demographic characteristics but did not include clinical diagnoses.”

Funders for this research include National Institute of Health, Penn Center for Precision Medicine.

The news reporters obtained a quote from the research from the University of Pennsylvania, “Thus, accurate coding by clinicians of inpatient and outpatient encounters ensures capitated payments and reimbursements that are commensurate with predicted expenditures. Pulmonary diseases and various forms of critical illness play a significant role in this risk adjustment process both through their associated HCC codes and through interactions with other risk categories representing cardiac and psychiatric diseases.”

According to the news reporters, the research concluded: “Ongoing uncertainty in federal health policy ensures a changing role for HCCs and risk-adjusted reimbursements across a variety of payment models and federal programs.”

For more information on this research see: Hierarchical Condition Categories for Pulmonary Diseases Population Health Management and Policy Opportunities. CHEST Journal, 2019;155(4):868-873. CHEST Journal can be contacted at: Elsevier Science Bv, PO Box 211, 1000 Ae Amsterdam, Netherlands.

Our news correspondents report that additional information may be obtained by contacting G.E. Weissman, University of Pennsylvania, Perelman School of Medicine, Dept. of Medicine, Pulm Allergy & Crit Care Div, Palliat & Adv Illne, Philadelphia, PA 19104, United States.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.chest.2018.12.013. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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