I have a question regarding risk-adjustment. I recently read an
article
where some researchers developed some risk-adjustment models for
detecting outlier hospitals based on the hospital's c-section rate. A
logistic regression model was fit using data from all of the hospitals
in the study. Each hospital's average predicted c-section rate was
obtained using the model. Then each hospital's "adjusted" rate was
calculated by dividing the observed hospital c-section rate by the
mean predicted rate at that hospital and multiplying that by the
overall c-section rate of all the hospitals.
I am hoping to do a similar type thing with some PCP cost data. I
want to "adjust" a PCP's cost in hopes of identifying outliers this
way. My outcome is continuous (total cost per member per month -
pmpm) and so I will obviously not use logistic regression. I am
somewhat new to risk-adjustment and my big qustion is, can I still do
this - obtain each PCP's predicted pmpm cost,
divide it by the actual cost and multiply by the overall pmpm cost.
Is this "legal"?
Any input woulf be greatly appreciated.
Thanks.
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