Improving the AAPCC (adjusted average per capita cost) with health-status measures from the MCBS (Medicare Current Beneficiary Survey).
Using data from the 1991 Medicare Current Beneficiary Survey (MCBS), multiple regression-based models predicting 1992 Medicare costs are developed and compared. A comprehensive model incorporating demographic, diagnostic, perceived health, and disability variables is shown to be stable and to fit the data well over the full range of Medicare-covered annual per capita expenses and for a variety of beneficiary subgroups defined by their health and functional status. This model produces stable unbiased estimates of expenditures on validation samples. A variant of this model is being considered for use in setting Medicare capitation payments for the second phase of the social/health maintenance organization (S/HMO) demonstration.
Gruenberg
L
L
DataChron Health Systems, Inc., Cambridge, MA 02139, USA.
Kaganova
E
E
Hornbrook
M C
MC
D000203:Activities of Daily Living; D000368:Aged; D002204:Capitation Fee; D002908:Chronic Disease / Q000145:classification / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D017048:Health Care Costs; D006279:Health Maintenance Organizations / Q000191:economics* / Q000592:standards; D006305:Health Status Indicators; D006801:Humans; D015273:Insurance Selection Bias; D008297:Male; D006278:Medicare / Q000458:organization & administration* / Q000706:statistics & numerical data; D018803:Models, Economic; D012044:Regression Analysis; D012308:Risk Management; D014481:United States