The purpose of this study was to compare different risk adjustment models in terms of their predictive ability to explain outcome differences across patients receiving post-acute care (PAC) services. Specifically, we compare (1) APR-DRG severity of illness (SOI) levels; (2) KNG Health Consulting’s risk adjustment model; and (3) risk adjustment models used in CMS’ quality measures. In addition, we present outcome measures that are standardized using APR-DRGs among patients receiving care in different PAC settings. We use the 2014 Q4 – 2016 Q4 Medicare Inpatient, Skilled Nursing Facility, and Home Health Agency Standard Analytic Files and 2013-2016 Denominator Files to conduct the analysis.
We examine the effectiveness of different risk adjustment models in explaining the following four outcomes: 90-day mortality, 90-day readmission rates, 90-day Medicare episode payments, and admission to a long-term acute care hospital.Services : Health Economics & Outcomes Research Expertise: Comparative Effectiveness, Health Outcomes and Evaluation