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. Author manuscript; available in PMC: 2020 Apr 23.
Published in final edited form as: Am J Health Econ. 2019 Apr 23;5(2):281–301.

Table 3.

The Ten HCC’s with the Most Positive and Most Negative Margins Minus an Arbitrary Constant Using Pooled Results for the Non-Group Business of Both Insurers for Both Years*

HCC1 HCC2 HCC3 Adjusted Margin Unadjusted Margin
The Ten Most Positive HCC’s or Combinations
Disorders of Immunity 0.582 0.864
Diabetes with Renal or Peripheral Circulatory Manifestation Polyneuropathy Vascular Disease /Renal Failure** 0.487 0.497
Congestive Heart Failure Renal Failure 0.343 0.252
Diabetes with Neurologic or Other Specified Manifestation Polyneuropathy Chronic Obstructive Pulmonary Disease 0.332 0.251
Diabetes without Complication Congestive Heart Failure Chronic Obstructive Pulmonary Disease 0.284 0.115
Major Depressive, Bipolar, and Paranoid Disorders Vascular Disease 0.241 0.279
Diabetes with Renal or Peripheral Circulatory Manifestation Polyneuropathy Vascular Disease 0.222 0.169
Diabetes with Renal or Peripheral Circulatory Manifestation Polyneuropathy Renal Failure 0.212 0.263
Vascular Disease Chronic Obstructive Pulmonary Disease Renal Failure 0.186 0.247
Diabetes with Renal or Peripheral Circulatory Manifestation Vascular Disease Renal Failure 0.176 0.188
The Ten Most Negative HCC’s or Combinations
Hip Fracture/Dislocation −0.501 −0.541
Congestive Heart Failure Vascular Disease Chronic Obstructive Pulmonary Disease −0.503 −0.630
Diabetes with Ophthalmologic or Unspecified Manifestation Vascular Disease −0.506 −0.577
Angina Pectoris/Old Myocardial Infarction Specified Heart Arrhythmias Vascular Disease −0.518 −0.578
Breast, Prostate, Colorectal and Other Cancers and Tumors Angina Pectoris/Old Myocardial Infarction −0.525 −0.558
Inflammatory Bowel Disease −0.565 −0.560
Congestive Heart Failure Angina Pectoris/Old Myocardial Infarction Vascular Disease −0.600 −0.705
Diabetes without Complication Congestive Heart Failure Vascular Disease −0.601 −0.693
Lung, Upper Digestive Tract, and Other Severe Cancers −0.643 −0.672
Congestive Heart Failure Angina Pectoris/Old Myocardial Infarction Specified Heart Arrhythmias/Vascular Disease** −0.703 −0.792
*

Margin is Revenue from HCCi/Medical and Drug Cost of HCCi - 1. An arbitrary constant has been subtracted from each value to preserve confidentiality.

**

For these two rows only, there were four conditions that were coded; to save adding a column, we show both the third and fourth comorbidity in one cell.