Sample Selection for Medicare Risk Adjustment Due to Systematically Missing Data.

ABSTRACT:

Objective

To assess the issue of nonrepresentative sampling in Medicare Advantage (MA) risk adjustment.

Data sources

Medicare enrollment and claims data from 2008 to 2011.

Data extraction

Risk adjustment predictor variables were created from 2008 to 2010 Part A and B claims and the Medicare Beneficiary Summary File. Spending is based on 2009-2011 Part A and B, Durable Medical Equipment, and Home Health Agency claims files.

Study design

A propensity-score matched sample of Traditional Medicare (TM) beneficiaries who resembled MA enrollees was created. Risk adjustment formulas were estimated using multiple techniques, and performance was evaluated based on R² , predictive ratios, and formula coefficients in the matched sample and a random sample of TM

SUBMITTER: Bergquist SL 

PROVIDER: S-EPMC6232496 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature