Browsing by Author "Fakhraei, S. Hamid"
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Item Comorbidity-Based Payment Methodology for Medicaid Enrollees with HIV/AIDS(2001) Fakhraei, S. Hamid; Kaelin, John J.; Conviser, RichardManaged care organizations (MCOs) may be incurring financial losses from persons with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) (PWHA). This study developed a statistical model to examine which specific comorbidities are important contributors to the variations in health care costs of PWHA. Individuals were classified into cost groups to simulate biased selection in MCOs. Capitation payments for various cost groups under different methodologies were compared. The statistical model closely matched payments with the actual costs of care. Capitation payments for HIV/AIDS enrollees based on this model will better protect MCOs than the traditional riskadjustment methods.Item Payments for physician services: an analysis of Maryland Medicaid reimbursement rates(Inderscience Enterprises Ltd, 2006) Fakhraei, S. HamidThis paper describes the process of increasing reimbursement rates for physicians who provide services to Maryland Medicaid enrollees. It compares Maryland Medicaid reimbursement rates for physicians with Medicare fees in Maryland and Medicaid reimbursement rates of other states. It also provides an analysis of the impact of the increases in reimbursement rates on the participation of physicians in the Medicaid programme. Based on the analysis presented in this article, which targets the increase in reimbursement rates to evaluation and management procedures, the Maryland Government increased physician fees in the Medicaid programme beginning July 2002. Evaluation and management procedures are usually office visits provided by either a primary care physician or a specialist.