Table 3.
Incremental modeling of 90‐day episode cost for lower extremity joint replacement (LEJR) for CMS, HVHC, and Mayo Clinic, Rochester, Minnesota populations (2013). All estimates were calculated utilizing the Youden Index for selecting optimal cut points for evaluation
| CMS LEJR population | HVHC LEJR subpopulation | Mayo LEJR subpopulation | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C‐Stat | Sens | Spec | PPV | NPV | C‐Stat | Sens | Spec | PPV | NPV | C‐Stat | Sens | Spec | PPV | NPV | |
| 1. Base (CJR Program) | 0.714 | 42.4% | 93.3% | 28.9% | 85.2% | 0.628 | 53.5% | 69.5% | 20.9% | 90.9% | 0.587 | 20.8% | 96.7% | 13.2% | 90.3% |
| 2. Base + HCC | 0.758 | 59.2% | 82.4% | 49.2% | 84.2% | 0.692 | 58.4% | 70.2% | 22.8% | 91.8% | 0.677 | 40.6% | 87.6% | 27.2% | 90.3% |
| 3. Base + HCC + Age | 0.780 | 63.1% | 80.6% | 49.6% | 85.1% | 0.721 | 70.6% | 61.8% | 21.8% | 93.3% | 0.721 | 67.0% | 65.8% | 27.7% | 90.8% |
| 4. Base + HCC + SES | 0.784 | 64.8% | 78.4% | 49.4% | 85.0% | 0.729 | 62.3% | 71.1% | 24.5% | 92.6% | 0.737 | 54.7% | 83.6% | 27.5% | 91.0% |
| 5. Base + HCC + Mar | 0.735 | 70.0% | 64.6% | 22.9% | 93.4% | 0.727 | 61.3% | 73.5% | 26.7% | 91.0% | |||||
| 6 Base + HCC + BMI | 0.718 | 65.3% | 62.1% | 20.6% | 92.2% | 0.721 | 79.5% | 54.9% | 23.2% | 91.3% | |||||
| 7. Base + HCC + Fnctn | 0.783 | 76.8% | 69.2% | 18.9% | 91.0% | ||||||||||
BMI, body mass index; CJR, Comprehensive Care for Joint Replacement Program; CMS, Centers for Medicare and Medicaid Services; C‐Stat, C‐Statistic; Fnctn, functional status; HCC, Hierarchical Condition Categories (CMS Version); HVHC, High Value Healthcare Collaborative; Mar, marital status; NPV, negative predictive value; PPV, positive predictive value; Sens, sensitivity; SES, socioeconomic status; Spec, specificity.
1. Base (CJR Program): Hip Fracture and Provider Region (not applicable in Mayo Clinic population).
2. Base + HCC: Hip Fracture, Provider Region, and the 5 HCC Conditions.
3. Base + HCC + Age: Hip Fracture, Provider Region, the 5 HCC Conditions, and Age.
4. Base + HCC + SES: Hip Fracture, Provider Region, the 5 HCC Conditions, Age, Dual Eligibility.
5. Base + HCC + Mar Status: Hip Fracture, 5 HCC Conditions, Age, Marital Status.
6. Base + HCC + BMI: Hip Fracture, 5 HCC Conditions, Age, (BMI) Body Mass Index.
7. Base + HCC + Function: Hip Fracture, 5 HCC Conditions, Age, Ability to Climb Two Flights of Stairs.