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Updated: Aug 26, 2026

An R-Based Landscape Validation of a Competing Risk Model
Published on: September 16, 2022
Medicare calibration of the clinically detailed risk information system for cost
Kanika Kapur1, Chien-Wen Tseng, Afshin Rastegar
1University of Hawaii, USA. kapur@rand.org
Abstract:
The clinically detailed risk information system for cost (CD-RISC) contains definitions for several hundred severity-adjusted conditions that can be used to predict future health care costs. We develop a prospective Medicare CD-RISC model using a 5-percent sample of Medicare beneficiaries and data that contain 1996 diagnostic information and 1997 annualized costs. The CD-RISC model has a hierarchical structure that implies that only the most expensive condition-severity variable within a body system affects payments. This minimizes incentives to game the system by entering multiple related codes for the same condition. The R2 for the CD-RISC model is 11 percent.
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