Integrating a Frailty Index into the CMS Hierarchical Condition Category Model for Predicting Health Care Costs
2024

Improving Medicare Cost Predictions with a Frailty Index

Sample size: 60000 publication Evidence: moderate

Author Information

Author(s): Jang Jieun, McCarthy Ellen, Olivieri-Mui Brianne, Shi Sandra, Park Chan Mi, Sison Stephanie Denise, Kim Dae Hyun

Primary Institution: Yonsei University Graduate School of Public Health

Hypothesis

Can a claims-based frailty index enhance the predictive capability of the CMS-HCC score for Medicare costs?

Conclusion

Incorporating a frailty index with the CMS-HCC score significantly improves the prediction of high Medicare costs.

Supporting Evidence

  • The study analyzed 1,855 surgical inpatients and 58,492 outpatients.
  • The added value of the frailty index improved predictive capability by up to 12.3% for annual costs in outpatients.
  • Using the frailty index helped identify patients at high risk of incurring substantial medical costs.

Takeaway

This study found that adding a frailty index to a standard Medicare cost prediction tool helps better identify patients who might have high medical costs.

Methodology

The study analyzed electronic health records linked with Medicare data for surgical inpatients and outpatients, using logistic regression and generalized estimating equations.

Participant Demographics

Patients over 65, including surgical inpatients and outpatients.

Digital Object Identifier (DOI)

10.1093/geroni/igae098.1263

Want to read the original?

Access the complete publication on the publisher's website

View Original Publication