reports

Applicability of predictive risk groupers to MHS data model. Deliverable 8: interim analysis of results

Reston, VA, USA: AdvanceMed Corp.

AdvanceMed Corp., Reston, VA, USA

AdvanceMed Corporation, a DynCorp company, is supporting the TRICARE Management Activity (TMA) and its health Program Analysis and Evaluation Directorate (HPA&E) in a project to test and compare the applicability of leading models of predictive healthcare science to Military Health System (MHS) data and management challenges for improving resource management and planning.
This study is the first ever conducted to compare MHS data to normative standards using industry accepted predictive risk groupers and peer-reviewed clinical risk adjustment models. The project will provide TMA’s senior leadership with powerful information and data in support of its mission to

• Deliver a fit, healthy and medically protected force,
• Deliver high quality care and improve health outcomes,
• Obtain appropriate resources,
• Determine and account for readiness costs, and
• Optimize stewardship of resources

This Interim Report provides an evaluation of the selected risk groupers applied to the MHS Study Group sample population, given certain unique characteristics of MHS data. It examines different grouper results in assessing the population health risk among three MHS regions, based on a sample of 199,565 TRICARE enrollees, and evaluates different methods for predicting future risk among these same populations and of disease-specific sub-populations. It also discusses the appropriateness of external benchmarks for risk evaluation and cost projections.