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Full One Year Warranty! Although researchers have found that diagnosis-based risk adjustment methodologies perform better than simple age—gender adjustments in predicting resource utilization in various populations Ash, Ellis, Pope, etal. Thus, a critical question for health care organizations will be whether simple modifications to existing risk adjustment systems can improve model performance. Another related question will dxg 578 how well these diagnosis-based risk adjustment systems perform in clinically meaningful subgroups within new populations.

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Previous studies suggest that for some subgroups of Medicare beneficiaries e. Similarly, among Medicaid beneficiaries, diagnosis-based risk adjustment systems are better able to predict expenditures for individuals with disabilities than for individuals who receive Aid to Families with Dependent Children AFDC Kronick etal. We found in previous work that Diagnostic Cost Groups DCGsa leading diagnosis-based risk adjustment system developed to predict future costs for Medicare beneficiaries, performed moderately well in explaining variation in concurrent utilization when applied to a different health care dxg 578 the Department of Veterans Affairs VA Rosen etal.

However, the model performed least well among those veterans with the highest utilization, where utilization was significantly underpredicted. Because DCGs were developed in a population with a low prevalence of substance abuse disorders approximately 50 percent lower than the VAwe expected that the system would not be adequate in classifying VA patients with SA disorders into homogeneous groupings. In particular, because of the variation in the utilization patterns of patients with SA disorders Horgan and Jencks ; Olfson and Pincus ; Simon and Unutzer ; Fortney, Booth, and Curranwe expected that the DCG models were likely to underestimate the rates of expensive subgroups of SA patients and overestimate the rates of other less expensive subgroups Pope etal.

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