HCC scores provided to MA plans for risk adjustment of revenue can also be used to identify hospitalization risk. Additional studies are required to evaluate whether a hybrid approach incorporating administrative and self-reported models would further optimize risk stratification efforts.

No abstract

This article describes collaborative health services research and performance evaluation activities at United HealthCare Corporation, a national health care management services company. We outline the development of a research capacity within our company, the principal data sources used, and the types of research conducted. The importance of health services research within a managed care system is illustrated using two projects as examples. finally, we discuss issues faced by organizations such as ours in defining appropriate research priorities, ensuring health plan participation, and disseminating research findings. Lessons learned should be of interest to health services researchers working in or collaborating with managed care organizations as well as others seeking to understand the dynamics of research in private-sector health care companies.

No abstract

No abstract