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Medicare calibration of the clinically detailed risk information system for cost
Kapur, Kanika; Tseng, Chien-Wen; Rastegar, Afshin; Carter, Grace; Keeler, Emmett
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 R² for the CD-RISC model is 11 percent.
Keyword(s): Insurance, health; Medical care, cost of; Medicare; Health Risk Assessment; Medical care, Cost of; Health risk assessment
Publication Date:
Type: Journal article
Peer-Reviewed: Unknown
Language(s): English
Institution: University College Dublin
Publisher(s): Centers for Medicare & Medicaid Services (CMS) / U.S. Government Printing Office
File Format(s): other; application/pdf
First Indexed: 2012-08-25 05:24:55 Last Updated: 2018-10-11 16:41:33