Evaluating alternative risk adjusters for Medicare.
Pope, Gregory C
Date of Pub
Adamache, Killard W; Khandker, Rezaul K; Walsh, Edith G
In this study the authors use 3 years of the Medicare Current Beneficiary Survey (MCBS) to evaluate alternative demographic,
survey, and claims-based risk adjusters for Medicare capitation payment. The survey health-status models have three to four
times the predictive power of the demographic models. The risk-adjustment model derived from claims diagnoses have 75-percent
greater predictive power than a comprehensive survey model. No single model predicts average expenditures well for all beneficiary
subgroups of interest, suggesting a combined model may be appropriate. More data are needed to obtain stable estimates of
model parameters. Advantages and disadvantages of alternative risk adjusters are discussed.
Managed Care Programs : Medicare : Aged : Economics, Medical : Health Services Research/economics : Health Surveys : Human
: Models, Econometric : Patient Satisfaction : Regression Analysis : Support, U.S. Gov't, Non-P.H.S. : United States