ENTREPRENEURSHIP

Detailed explanation-1: -A statistical process that takes into account the underlying health status and health spending of the enrollees in an insurance plan when looking at their health care outcomes or health care costs.

Detailed explanation-2: -A risk adjustment factor is a calculation of an individual’s health status as a number, or risk score, that helps predict costs for healthcare services. Health plans adjust the risk incurred from insuring members with expected higher healthcare costs by insuring members with expected lower healthcare costs.

Detailed explanation-3: -The Pharma Documentation Ring (P-D-R), founded in 1958, is a think tank of information and knowledge-management professionals representing major research-based pharmaceutical companies. The association has four aims: Promote exchange of knowledge among members.

Detailed explanation-4: -Risk adjustment modifies payments to all insurers based on an expectation of what the patient’s care will cost. For example, a patient with type 2 diabetes and high blood pressure merits a higher set payment than a healthy patient, for example.