
FIGURE 1: Performance of Alternative and Current RiskAdjustment Models for Improvement in ADL Outcomes

FIGURE 1. Performance of Alternative and Current RiskAdjustment Models for Improvement in ADL Outcomes Performance of Alternative and Current RiskAdjustment Models for Stabilization in ADL Outcomes NOTE: Vertical height (the yaxis) indicates the explanatory power of the alternative riskadjustment models with: (1) only the core risk factors (the dark shade at the bottom of the column), (2) the addition of the outcome specific riskadjusters (the speckled section), and (3) the addition of relevant “prior” OASIS items (the light shade at the top of the column). The short, solid line above or within the column indicates the explanatory power of the current (“U of CO”) riskadjustment model. See methods section for the definition of the pseudoRsquared measure of explanatory power.


FIGURE 2: Performance of Alternative and Current RiskAdjustment Models for Improvement in IADL Outcomes

FIGURE 2. Performance of Alternative and Current RiskAdjustment Models for Improvement in IADL Outcomes Performance of Alternative and Current RiskAdjustment Models for Stabilization in IADL Outcomes NOTE: Vertical height (the yaxis) indicates the explanatory power of the alternative riskadjustment models with: (1) only the core risk factors (the dark shade at the bottom of the column), (2) the addition of the outcome specific riskadjusters (the speckled section), and (3) the addition of relevant “prior” OASIS items (the light shade at the top of the column). The short, solid line above or within the column indicates the explanatory power of the current (“U of CO”) riskadjustment model. See methods section for the definition of the pseudoRsquared measure of explanatory power.


FIGURE 3: Performance of Alternative and Current RiskAdjustment Models for Improvement in Physiologic and Cognitive Outcomes

FIGURE 3. Performance of Alternative and Current RiskAdjustment Models for Improvement in Physiologic and Cognitive Outcomes NOTE: Vertical height (the yaxis) indicates the explanatory power of the alternative riskadjustment models with: (1) only the core risk factors (the dark shade at the bottom of the column), (2) the addition of the outcome specific riskadjusters (the speckled section), and (3) the addition of relevant “prior” OASIS items (the light shade at the top of the column). The short, solid line above or within the column indicates the explanatory power of the current (“U of CO”) riskadjustment model. See methods section for the definition of the pseudoRsquared measure of explanatory power.


FIGURE 4: Performance of Alternative and Current RiskAdjustment Models for Utilization Outcomes

FIGURE 3. Performance of Alternative and Current RiskAdjustment Models for Improvement in Physiologic and Cognitive Outcomes NOTE: Vertical height (the yaxis) indicates the explanatory power of the alternative riskadjustment models with: (1) only the core risk factors (the dark shade at the bottom of the column), (2) the addition of the outcome specific riskadjusters (the speckled section), and (3) the addition of relevant “prior” OASIS items (the light shade at the top of the column). The short, solid line above or within the column indicates the explanatory power of the current (“U of CO”) riskadjustment model. See methods section for the definition of the pseudoRsquared measure of explanatory power.


FIGURE 5: Inclusion of OASISB1 Items in RiskAdjustment Models

FIGURE 5. Inclusion of OASISB1 Items in RiskAdjustment Models M0200 M0220 M0100 M0190 M0210 M0280 M0066 M0250* M0290 M0300 M0340 M0350 M0360 M0140 M0180 M0069 M0150 M0430 M0500 M0370 M0380 M0400 M0450* M0474 M0486 M0175* M0230* M0510 M0640P M0650P M0464 M0470 M0484 M0810 M0820 M0230S* M0240* M0240S* M0260 M0660P M0670P M0488* M0550* M0620 M0825* M0270 M0390* M0410 M0420* M0440* M0680P M0690P M0630 M0730P M0790 M0445 M0460* M0468 M0476* M0482 M0700P M0710P M0720P M0790P M0800 M0490* M0520 M0530* M0540* M0560 M0570 M0580 M0740P M0750P M0800P M0590 M0610* M0640 M0650* M0660* M0670* M0680* M0690* M0760P M0770P M0700* M0710 M0720 M0730 M0740 M0750 M0760 M0770 M0780 M0780P LEGEND Items used in: Core
(43)Full
(64)U of Co
Models
(88)Not
Used
(7)OASIS ITEM X OASIS ITEM X OASIS ITEM X X OASIS ITEM X X X NOTE: There is a total of 95 OASIS items for riskadjustment. * Item used in home health resource group casemix classification for Medicare payment.


FIGURE 6: Inclusion of OASISB1 Elements in RiskAdjustment Models

FIGURE 6. Inclusion of OASISB1 Elements in RiskAdjustment Models M0175_NA* M0100 M0150_1 M0190_A M0140_1 M0140_2 M0140_3 M0140_4 M0140_5 M0140_6 M0140_UK M0200 M0220_1 M0190_B M0210_A M0210_B M0150_0 M0150_5 M0150_6 M0150_7 M0150_8 M0150_9 M0150_10 M0150_11 M0220_2 M0220_3 M0220_4 M0210_C M0210_D M0220_UK M0150_UK M0175_5* M0180 M0220_7 M0220_NA M0250_3* M0250_4* M0066 M0220_5 M0220_6 M0250_1* M0250_2* M0280 M0290_4 M0290_3 M0340_4 M0340_5 M0340_6 M0825 M0350_3 M0069 M0150_2 M0290_1 M0290_2 M0290_3 M0300 M0340_1 M0340_2 M0380_3 M0380_4 M0380_5 M0380_6 M0380_7 M0150_3 M0150_4 M0175_1* M0290_UK M0430 M0340_3 M0350_1 M0350_2 M0350_4 M0380_UK M0450_E* M0474 M0486 M0175_2* M0175_3* M0175_4* M0230_A* M0300_2 M0510 M0350_UK M0360 M0370 M0380_1 M0500_3 M0500_4 M0550* M0230S_A* M0240_B* M0240_C* M0240_D* M0610_1* M0610_2* M0610_5* M0380_2 M0400 M0450_A* M0450_B* M0610_7* M0810 M0240_E* M0240_F* M0240S_B* M0240S_C_D* M0240S_D* M0640P M0650P M0660P M0450_C* M0450_D* M0464 M0470 M0820 M0240S_E* M0240S_F* M0260 M0270 M0390* M0410 M0670P M0680P M0690P M0484 M0488* M0500_1 M0610_4* M0420* M0440* M0445 M0460* M0468 M0476* M0482 M0700P M0710P M0720P M0610_6* M0620 M0630 M0490* M0520 M0530* M0540* M0560 M0570 M0580 M0590_1 M0590_2 M0740P M0750P M0730P M0790 M0590_3 M0590_4 M0590_5 M0590_6 M0610_3* M0640 M0650* M0660* M0670* M0680* M0760P M0790P M0800 M0690* M0700* M0710 M0720 M0730 M0740 M0750 M0760 M0770 M0780 M0770P M0780P M0800P LEGEND Elements Used In: Core
(61)Full
(93)U of Co
(135)Not Used
(43)OASIS Element X OASIS Element X OASIS Element X X OASIS Element X X X OASIS Element X X NOTE: There is a total of 180 OASIS elements for riskadjustment. * Item used in home health resource group casemix classification for Medicare payment.


FIGURE 7: Mean Percentage Point Difference in Agency Performance Using Current versus Full Alternative Models

FIGURE 7. Mean Percentage Point Difference in Agency Performance Using Current versus Full Alternative Models NOTE: Each point represents the average agency percentage point difference between patient outcomes predicted by the current model and the patient outcomes predicted by the full alternative model. Above and below each point is a set of bars representing a two standard deviation span for each outcome, centered on the mean.


FIGURE 8: Spearman’s Rank Correlation Coefficient for Agency Outcomes Using Current versus Full Alternative Models

FIGURE 8. Spearman’s Rank Correlation Coefficient for Agency Outcomes Using Current versus Full Alternative Models NOTE: Each point represents the value of Spearman’s rank correlation coefficient for the ordinal ranking of agencies on their patient outcomes using the current model compared to rankings using the full alternative riskadjustment model. It is a standard correlation coefficient, ranging from 1 to 1. In this figure, a value of 0 represents no relationship between the rankings, 1 represents perfectly opposite rankings, and 1 represents perfectly matching ranks produced by the models being compared. For purposes of presentation, only the range from 0.85 to 1 on the vertical (y) axis is shown in this figure.


FIGURE 9: Mean Percentage Point Difference in Agency Performance Using Current versus Core Alternative Models

FIGURE 9. Mean Percentage Point Difference in Agency Performance Using Current versus Core Alternative Models NOTE: Each point represents the average agency percentage point difference between patient outcomes predicted by the current model and the patient outcomes predicted by the core alternative model. Above and below each point is a set of bars representing a two standard deviation span for each outcome, centered on the mean.


FIGURE 10: Spearman’s Rank Correlation Coefficient for Agency Outcomes Using Current versus Core Alternative Models

FIGURE 10. Spearman’s Rank Correlation Coefficient for Agency Outcomes Using Current versus Core logic and Cognitive Outcomes NOTE: Each point represents the value of Spearman’s rank correlation coefficient for the ordinal ranking of agencies on their patient outcomes using the current model compared to rankings using the core alternative riskadjustment model. It is a standard correlation coefficient, ranging from 1 to 1. In this figure, a value of 0 represents no relationship between the rankings, 1 represents perfectly opposite rankings, and 1 represents perfectly matching ranks produced by the models being compared. For purposes of presentation, only the range from 085 to 1 on the vertical (y) axis is shown in this figure.

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