Risk Adjustment for Dually Eligible Beneficiaries Using Long-Term Care
نویسندگان
چکیده
This study explores use of the principal inpatient diagnostic cost groups (PIPDCG) and hierarchical coexisting conditions (HCC) risk-adjustment methodologies for a population of dually eligible beneficiaries receiving chronic long-term care (LTC). Measures of individual predictive accuracy for this population compared with the total Medicare population were similar for the PIPDCG models but somewhat smaller for the HCC models. Incorporating measures of functional status increased the R2 values by only a small amount for Medicare expenditures but by a somewhat larger amount for total expenditures. Addition of other variables, especially placement, further improved the predictive power.
منابع مشابه
End of Life Medicare and Medicaid Expenditures for Dually Eligible Beneficiaries
In 1995, combined Medicare and Medicaid spending in the last year of life for dually eligible beneficiaries was more than $40,000 per beneficiary. Medicaid's share, primarily for long-term care (LTC), constituted about 40 percent of the total. Beneficiaries under age 65, Black persons, and individuals who died in a hospital had higher than average expenditures. The vast majority (86 percent) re...
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