Post-Acute Care Episode Risk Adjustment Extrapolation Analyses

The goal of this project was to provide additional information to ASPE and CMS on the potential to risk adjust Medicare post-acute care (PAC) episode payments and costs using patient assessment data. The Continuity Assessment Record and Evaluation (CARE) data collected in the CMS Post-Acute Care Payment Reform Demonstration (PAC PRD) provide a unique opportunity to use the same set of items to predict PAC episode payments and costs, regardless of the setting in which a beneficiary begins and episode; however, CARE data collection across PAC settings in not currently required by CMS. In the absence of uniform assessment data, the item crosswalk approach used in this work was a useful tool to understand the potential to risk adjust episodes using assessment data that is currently available and to understand the generalizability of the results of the risk adjustment models developed using the PAC PRD sample.