Medicare calibration of the clinically detailed risk information system for cost

Kanika Kapur, Chien-Wen Tseng, Afshin Rastegar, Grace Carter and Emmett Keeler

Open Access publications from School of Economics, University College Dublin

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.

Keywords: Insurance, health; Medical care, cost of; Medicare; Health Risk Assessment; Medical care, Cost of; Medicare; Health risk assessment (search for similar items in EconPapers)
Pages: 18 pages
Date: 2003
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

Published in: Health Care Financing Review, 25(1) 2003

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http://hdl.handle.net/10197/274 Open Access version, 2003 (application/pdf)

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Persistent link: https://EconPapers.repec.org/RePEc:ucn:oapubs:10197/274

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