Table 4. Predictive Ratios Based on Risk-Adjustment Models Incorporating Institutional Status: Pooled Data, 1991-1994.
| Model | Total | Non-Institutionalized | Institutionalized | ||||
|---|---|---|---|---|---|---|---|
|
| |||||||
| All | 0 ADL | 1-2 ADLs | 3-4 ADLs | 5-6 ADLs | |||
| Medicare | |||||||
| PIPDCG | 1.00 | 1.00 | 1.29 | 0.85 | 0.71 | 0.57 | 1.00 |
| HCC | 1.00 | 1.00 | 1.20 | 0.90 | 0.80 | 0.68 | 1.00 |
| Dually Eligible | |||||||
| PIPDCG | 0.99 | 0.99 | 1.36 | 1.04 | 0.78 | 0.59 | 1.03 |
| HCC | 1.00 | 1.00 | 1.29 | 1.06 | 0.84 | 0.67 | 1.00 |
NOTES: ADL is activity of daily living. ADL status was measured in the base years. A predictive ratio is the ratio of predicted to actual average Medicare expenses, excluding hospice expenses. The predictive ratio for total dually eligible beneficiaries is not always 1.0 because the models were calibrated on the full study sample, not the subset of dually eligible persons. Analysis is based on 32,228 Medicare cases and 5,471 dually eligible cases (unweighted). PIPDCG is principal inpatient diagnostic cost group. HCC is hierarchial coexisting condition.
SOURCE: Medicare Current Beneficiary Survey, 1991-1994.