Medicare Health Outcomes Survey: Case mix methodologies

This presentation provides methodologies for case mix measures using the Veterans RAND 12 Item Health Survey (VR-12) as the outcome. The VR-12 is modified from the Veterans RAND 36 Item Health Survey and the RAND SF-36. This measure of functional status and well being spans the domains of physical to psychological functioning. The VR-12 has recently been included as one of the performance measures in the HEDIS 2006 Information Data Set. The objectives of this presentation are to examine measures of health at baseline and at follow-up for purposes of case mix adjustment using the VR-12 PCS (physical function) and MCS (mental function) scores for measuring the performance of health plans over two years in the Medicare Advantage Program. The Medicare Health Outcomes Survey for managed care health plans is a cohort design with a baseline sample and a follow-up 2 years later. Cohorts using the VR-12 began in 2006 round 7 at follow-up. The recent addition of the VR-12 for the transition year affords researchers the opportunity to investigate risk adjustments for monitoring changes in health using the 12 item versions including the RAND SF-12 and the VR-12. The case mix methodology for performance measurement (monitoring health outcomes over 2 years) uses separate case mix models for death, change in PCS and change in MCS. The models for change in PCS or MCS are the same or better versus worse. Scores are reported as the percentage of respondents within a plan who are better, same or (worse and died).