| Sumario: | Part of a special section on dually eligible Medicare and Medicaid beneficiaries. The writers use three years of Medicare Current Beneficiary Survey to assess alternative demographic, survey, and claims-based risk adjusters for Medicare capitation payment. They contend that the survey health-status models have three to four times the predictive power of the demographic models. In addition, the assert that the risk-adjustment model derived from claims diagnoses has 75-percent greater predictive power than a comprehensive survey model. Furthermore, they argue that no single model predicts average expenditures well for all beneficiaries subgroups of interest, implying that a combined model may be appropriate. They conclude that more data are required to obtain stable estimates of model parameters and consider the advantages and disadvantages of alternative risk adjusters.
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