Table 5. Predictive Ratios for Selected Characteristics.

Characteristic	BlueCross® BlueShield® Sample			Medicaid Sample			Total
	Observations	Age/Sex Model	RxHCC Model	Observations	Age/Sex Model	RxHCC Model	Observations	Age/Sex Model	RxHCC Model
All Enrollees	726,705	0.994	0.999	130,207	1.007	1.009	856,912	0.995	1.000
Deciles—Year 2 Predicted Plan Liability
First (Lowest)	72,671	3.429	1.543	13,021	2.860	1.240	85,691	3.392	1.517
Second	72,671	1.668	1.054	13,021	2.434	1.262	85,691	1.750	1.076
Third	72,671	1.276	0.975	13,021	1.535	1.019	85,691	1.299	0.979
Fourth	72,671	1.100	0.952	13,021	1.228	0.966	85,691	1.109	0.952
Fifth	72,671	0.977	0.934	13,021	1.060	0.943	85,691	0.984	0.935
Sixth	72,670	0.901	0.935	13,021	0.941	0.939	85,691	0.901	0.934
Seventh	72,670	0.835	0.942	13,021	0.864	0.944	85,691	0.836	0.942
Eighth	72,670	0.782	0.961	13,020	0.797	0.974	85,691	0.783	0.964
Nine	72,670	0.731	0.994	13,020	0.734	1.015	85,691	0.731	0.998
Tenth (Highest)	72,670	0.666	1.088	13,020	0.590	1.072	85,691	0.656	1.087
Hospitalizations—Year 1
0	584,530	1.072	1.001	98,163	1.077	0.991	685,693	1.072	1.000
1	91,685	0.818	0.983	18,170	0.809	1.025	109,555	0.817	0.988
2	31,465	0.746	0.998	6,969	0.738	1.054	38,434	0.745	1.006
3	10,802	0.691	1.012	3,142	0.688	1.058	13,944	0.690	1.020
4+	8,223	0.658	1.049	3,763	0.652	1.141	11,986	0.656	1.074

NOTES: Predictive ratios greater than 1.0 indicate overprediction; ratios less than 1 denote underprediction. RxHCC is prescription drug hierarchical condition categories. Data represent 1999/2000 Medicare and Medicaid beneficiaries and 2001/2002 BC^®BS^® enrollees.

SOURCE: Robst, J., University of South Florida, Levy, J.M., Centers for Medicare & Medicaid Services, and Ingber, M.J., RTI International, 2007.