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The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
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Mechanistic models are utilized in individual analysis using single-source data, but imperfections arise due to data collection errors, preventing perfect prediction of observed data. The mathematical equation involves known values (Xi), observed concentrations (Ci), measurement errors (εi), model parameters (ϕj), and the related function (ƒi) for i number of values. Different least-squares metrics quantify differences between predicted and observed values. The ordinary least...
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Developing Models to Predict Persistent High-Cost Cases in Florida Medicaid.

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Identifying persistent high-cost Medicaid cases is possible using past service use and diagnoses. Intermediate care facility services strongly predict future high costs, informing targeted interventions for healthcare cost management.

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Area of Science:

  • Health Services Research
  • Medical Economics
  • Public Health Policy

Background:

  • High-cost cases represent a significant financial burden on healthcare systems.
  • Understanding the characteristics and predictors of persistent high-cost cases is crucial for resource allocation and intervention strategies.
  • Medicaid beneficiaries often exhibit complex health needs, contributing to higher healthcare expenditures.

Purpose of the Study:

  • To identify individual characteristics associated with being a persistent high-cost case in Medicaid.
  • To evaluate the accuracy of predictive models for identifying future persistent high-cost cases.
  • To inform the development of targeted interventions for high-cost individuals.

Main Methods:

  • Analysis of Florida Medicaid claims data from 2005 to 2010.
  • Estimation of regression models using diagnoses and service utilization in a base year to predict future high-cost status.
  • Examination of various predictive perspectives, including prior persistence and future persistence.

Main Results:

  • Persistent high-cost cases incurred average annual costs exceeding $140,000.
  • Predictive models demonstrated accuracy in identifying future high-cost cases.
  • Receipt of intermediate care facility services was the strongest predictor of future high-cost cases.
  • Inpatient, outpatient, pharmacy, and nursing home services, along with diagnoses, were significant predictors.

Conclusions:

  • Diagnosis-based models combined with prior cost data can accurately predict future high-cost Medicaid cases.
  • The strong association with intermediate care facility services raises questions about the applicability of intensive case management for all high-cost individuals.
  • Service use patterns, diagnoses, and prior costs are essential components for identifying individuals who may benefit from intensive case management.