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Claims-Based Frailty Index Can Improve Cost Prediction

Addition of frailty index to CMS-HCC model improves cost prediction over CMS-HCC model alone

hospital patient with walker and nurse

WEDNESDAY, April 8, 2020 (HealthDay News) -- A claims-based frailty index can improve current Medicare cost prediction for patients with different levels of frailty, according to a study published online April 7 in the Annals of Internal Medicine.

Kenton J. Johnston, Ph.D., from Saint Louis University, and colleagues conducted a retrospective cohort study to determine whether a claims-based frailty index can improve Medicare cost prediction. Participants included 16,535 community-dwelling, fee-for-service beneficiaries representing 26,705 patient-years; their frailty status was classified using a validated claims-based frailty index.

The researchers found that the mean costs were $5,724, $12,462, $26,239, and $44,586 for the patients classified as robust, prefrail, mildly frail, and moderately to severely frail, respectively (46.4, 41.6, 9.6, and 2.5 percent of the patient-years, respectively). An additional $2,712, $7,915, and $16,449 in costs were predicted for prefrail, mildly frail, and moderately to severely frail, respectively, with the addition of the frailty index to the Centers for Medicare & Medicaid Services Hierarchical Condition Category (CMS-HCC) model beyond the CMS-HCC model alone. For patients at all four levels of frailty, the model with the frailty index addition resulted in more accurate predictions of costs.

"Because incorporation of the claims-based frailty index improved model performance in predicting cost, value-based payment models could reward providers, nonarbitrarily, for rendering services to frail patients," write the authors of an accompanying editorial.

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