Evaluating risk-adjustment methodologies for patients with mental health and substance abuse disorders in the veterans health administration
by Amy K. Rosen, Cindy L. Christiansen, Maria E. Montez, Susan Loveland, Priti Shokeen, Kevin L. Sloan, Susan L. Ettner
International Journal of Healthcare Technology and Management (IJHTM), Vol. 7, No. 1/2, 2006

Abstract: Although the difficulties in applying existing risk-adjustment measures to mental health populations are increasingly evident, the need for adequate risk-adjustment methodologies continues to increase due to the ongoing pressures of the need to constrain costs and allocate resources equitably across key population sub-groups. The performance of several risk-adjustment measures in predicting total healthcare costs and Mental Health/Substance abuse (MH/SA) costs was compared with a national sample of patients with MH/SA disorders receiving healthcare services in the Department of Veterans Affairs (VA). Differences in the performances of the models in predicting both total and MH/SA costs were small; mean absolute prediction errors and predictive ratios did not demonstrate any clear ranking of model performance. Inequitable allocation of resources may result when models that have been developed specifically for general patient populations are applied to unique populations with different healthcare needs.

Online publication date: Thu, 29-Sep-2005

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