Hawkins Kevin, Ozminkowski Ronald J, Mujahid Asif, Wells Timothy S, Bhattarai Gandhi R, Wang Sara, Hommer Cynthia E, Huang Jinghua, Migliori Richard J, Yeh Charlotte S
1 Advanced Analytics, Optum Ann Arbor, Michigan.
2 Healthcare Analytics, Optum Consumer Solutions Group , Ann Arbor, Michigan.
Popul Health Manag. 2015 Dec;18(6):402-11. doi: 10.1089/pop.2014.0121. Epub 2015 Feb 6.
The objective was to develop a propensity to succeed (PTS) process for prioritizing outreach to individuals with Medicare Supplement (ie, Medigap) plans who qualified for a high-risk case management (HRCM) program. Demographic, socioeconomic, health status, and local health care supply data from previous HRCM program participants and nonparticipants were obtained from Medigap membership and health care claims data and public data sources. Three logistic regression models were estimated to find members with higher probabilities of engaging in the HRCM program, receiving high quality of care once engaged, and incurring enough monetary savings related to program participation to more than offset program costs. The logistic regression model intercepts and coefficients yielded the information required to build predictive models that were then applied to generate predicted probabilities of program engagement, high quality of care, and cost savings a priori for different members who later qualified for the HRCM program. Predicted probabilities from the engagement and cost models were then standardized and combined to obtain an overall PTS score, which was sorted from highest to lowest and used to prioritize outreach efforts to those newly eligible for the HRCM program. The validity of the predictive models also was estimated. The PTS models for engagement and financial savings were statistically valid. The combined PTS score based on those 2 components helped prioritize outreach to individuals who qualified for the HRCM program. Using PTS models may help increase program engagement and financial success of care coordination programs.
目标是开发一种成功倾向(PTS)流程,以便优先对符合高风险病例管理(HRCM)计划资格的拥有医疗保险补充(即医疗补助)计划的个人进行外展服务。从医疗补助会员资格、医疗保健理赔数据以及公共数据源中获取了之前HRCM计划参与者和非参与者的人口统计学、社会经济、健康状况及当地医疗保健供应数据。估计了三个逻辑回归模型,以找出参与HRCM计划概率较高、参与后能获得高质量护理且因参与计划而产生足够的资金节省以抵消计划成本的成员。逻辑回归模型的截距和系数产生了构建预测模型所需的信息,然后应用这些信息为先验地为后来符合HRCM计划资格的不同成员生成计划参与、高质量护理和成本节省的预测概率。然后对参与模型和成本模型的预测概率进行标准化并合并,以获得总体PTS分数,该分数从高到低排序,并用于优先对新符合HRCM计划资格的人进行外展工作。还估计了预测模型的有效性。参与和财务节省的PTS模型在统计上是有效的。基于这两个组成部分的综合PTS分数有助于优先对符合HRCM计划资格的个人进行外展服务。使用PTS模型可能有助于提高护理协调计划的参与度和财务成功率。