TITLE

Medicare Calibration of the Clinically Detailed Risk Information System for Cost

AUTHOR(S)
Kapur, Kanika; Chien-Wen Tseng; Rastegar, Afshin; Carter, Grace M.; Keeler, Emmett
PUB. DATE
September 2003
SOURCE
Health Care Financing Review;Fall2003, Vol. 25 Issue 1, p37
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The clinically detailed risk information system for cost (CD-RISC) contains definitions for several hundred severity-adjusted conditions that can be used to predict future health care costs. We develop a prospective Medicare CD-RISC model using a 5-percent sample of Medicare beneficiaries and data that contain 1996 diagnostic information and 1997 annualized costs. The CD-RISC model has a hierarchical structure that implies that only the most expensive condition-severity variable within a body system affects payments. This minimizes incentives to game the system by entering multiple related codes for the same condition. The R� for the CD-RISC model is 11 percent.
ACCESSION #
13063243

 

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