Medicare calibration of the clinically detailed risk information system for cost

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Title: Medicare calibration of the clinically detailed risk information system for cost
Authors: Kapur, Kanika
Tseng, Chien-Wen
Rastegar, Afshin
Carter, Grace
Keeler, Emmett
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Date: 2003
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 R² for the CD-RISC model is 11 percent.
Type of material: Journal Article
Publisher: Centers for Medicare & Medicaid Services (CMS) / U.S. Government Printing Office
Journal: Health Care Financing Review
Volume: 25
Issue: 1
Start page: 37
End page: 54
Keywords: Insurance, healthMedical care, cost ofMedicareHealth Risk Assessment
Subject LCSH: Medical care, Cost of
Health risk assessment
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Language: en
Status of Item: Peer reviewed
Appears in Collections:Geary Institute Research Collection
Economics Research Collection

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