Identifying high-cost episodes in lower extremity joint replacement.

ABSTRACT:

Objectives

To evaluate the ability of claims-based risk adjustment and incremental components of clinical data to identify 90-day episode costs among lower extremity joint replacement (LEJR) patients according to the Centers for Medicare & Medicaid Services (CMS) Comprehensive Care for Joint Replacement (CJR) program provisions.

Data sources

Medicare fee-for-service (FFS) data for qualifying CJR episodes in the United States, and FFS data linked with clinical data from CJR-qualifying LEJR episodes performed at High Value Healthcare Collaborative (HVHC) and Mayo Clinic in 2013. HVHC and Mayo Clinic populations are subsets of the total FFS population to assess the additive value of additional pieces of clinical data in correctly assigning patients to cost groups.

Study desi

SUBMITTER: Philpot LM 

PROVIDER: S-EPMC6338304 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature