RADAR
Development of an Enhanced Risk Adjustment Method for National OASIS Outcome
Reports
(Home Health Risk Adjustment Project)
Funded by: Centers for Medicare & Medicaid Services
Subcontract from: Delmarva Foundation for Medical Care
Project Period: 1/02 - 10/02
The purpose of this study is to design a range of alternative approaches to
statistically risk adjust a variety of different outcome measures of home
health care and then theoretically and empirically assess the different
methodologies in order to determine the optimal method for use in the CMS
national outcome reporting system for home health care.
The current methodology for risk adjustment of outcome reports for home health
agencies was developed, tested, and validated over the course of several years
as part of the outcome-based quality improvement (OBQI) research and
demonstration program. It has proven to be a practical and reasonably
effective means of controlling for variation in patient case mix when making
outcome comparisons between home health agencies and national reference values
as well as tracking outcome changes across time. However, there is room for
improvement in terms of the explanatory or predictive effectiveness of
statistical models used, particularly for selected outcome measures. In
addition to improving predictive accuracy, alternative methods of risk
adjustment deserve (re)consideration from the standpoint of other criteria
such as computational simplicity or understandability to a nonstatistical
audience. This project has two main objectives: (1) to explore and
empirically evaluate potential refinements to current risk adjustment models
and (2) to develop and evaluate the feasibility and effectiveness of
alternative approaches to risk adjustment.
Key Staff: Shaughnessy, Hittle, Powell
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