Table IV-1. CMS-HCC Dialysis Model [1],, Risk factors are relative to average total Medicare expenditures per capita for dialysis patients. [2],, Variable,Disease Group,Relative Factors Age/Sex Groups,, Male0_34 ,,0.647 Male 35_44,,0.651 Male 45_54,,0.673 Male 55_59,,0.721 Male 60_64,,0.715 Male 65_69,,0.769 Male 70_74,,0.781 Male 75_79,,0.799 Male 80_84,,0.826 Male 85_GT,,0.868 Female 0_34 ,,0.721 Female 35_44,,0.722 Female 45_54,,0.739 Female 55_59,,0.731 Female 60_64,,0.752 Female 65_69,,0.822 Female 70_74,,0.843 Female 75_79,,0.858 Female 80_84,,0.863 Female 85_GT,,0.913 Disease Group Factors,, HCC1 ,HIV/AIDS,0.186 HCC2 ,Septicemia/Shock,0.077 HCC5 ,Opportunistic Infections,0.068 HCC7 ,Metastatic Cancer and Acute Leukemia,0.168 HCC8,"Lung, Upper Digestive Tract, and Other Severe Cancers",0.168 HCC9 ,"Lymphatic, Head and Neck, Brain and Other Major Cancers",0.151 HCC10 ,"Breast, Prostate, Colorectal and Other Cancers and Tumors",0.049 HCC15,Diabetes with Renal or Peripheral Circulatory Manifestation,0.105 HCC16,Diabetes with Neurologic or Other Specified Manifestation,0.105 HCC17,Diabetes with Acute Complications,0.105 HCC18,Diabetes with Ophthalmologic or Unspecified Manifestation,0.105 HCC19,Diabetes without Complication,0.105 HCC21 ,Protein-Calorie Malnutrition,0.071 HCC25 ,End-Stage Liver Disease,0.116 HCC26 ,Cirrhosis of Liver,0.104 HCC27 ,Chronic Hepatitis,0.034 HCC31 ,Intestinal Obstruction/Perforation,0.065 HCC32 ,Pancreatic Disease,0.079 HCC33 ,Inflammatory Bowel Disease,0.103 HCC37 ,Bone/Joint/Muscle Infections/Necrosis,0.138 HCC38 ,Rheumatoid Arthritis and Inflammatory Connective Tissue Disease,0.093 HCC44 ,Severe Hematological Disorders,0.095 HCC45 ,Disorders of Immunity,0.061 HCC51 ,Drug/Alcohol Psychosis,0.029 HCC52 ,Drug/Alcohol Dependence,0.029 HCC54 ,Schizophrenia,0.116 HCC55,"Major Depressive, Bipolar, and Paranoid Disorders",0.116 HCC67,"Quadriplegia, Other Extensive Paralysis",0.261 HCC68,Paraplegia,0.261 HCC69 ,Spinal Cord Disorders/Injuries,0.091 HCC70 ,Muscular Dystrophy,0.075 HCC71 ,Polyneuropathy,0.049 HCC72 ,Multiple Sclerosis,0.082 HCC73 ,Parkinson's and Huntington's Diseases,0.037 HCC74 ,Seizure Disorders and Convulsions,0.069 HCC75,"Coma, Brain Compression/Anoxic Damage",0.073 HCC77 ,Respirator Dependence/Tracheostomy Status,0.195 HCC78 ,Respiratory Arrest,0.181 HCC79 ,Cardio-Respiratory Failure and Shock,0.065 HCC80 ,Congestive Heart Failure,0.083 HCC81 ,Acute Myocardial Infarction,0.097 HCC82,Unstable Angina and Other Acute Ischemic Heart Disease,0.097 HCC83 ,Angina Pectoris/Old Myocardial Infarction,0.036 HCC92 ,Specified Heart Arrhythmias,0.067 HCC95 ,Cerebral Hemorrhage,0.059 HCC96,Ischemic or Unspecified Stroke,0.059 HCC100 ,Hemiplegia/Hemiparesis,0.084 HCC101 ,Cerebral Palsy and Other Paralytic Syndromes,0.064 HCC104 ,Vascular Disease with Complications,0.145 HCC105 ,Vascular Disease,0.06 HCC107,Cystic Fibrosis,0.072 HCC108,Chronic Obstructive Pulmonary Disease,0.072 HCC111 ,Aspiration and Specified Bacterial Pneumonias,0.121 HCC112 ,"Pneumococcal Pneumonia, Emphysema, Lung Abscess",0.043 HCC119 ,Proliferative Diabetic Retinopathy and Vitreous Hemorrhage,0.037 HCC148 ,Decubitus Ulcer of Skin,0.177 HCC149 ,"Chronic Ulcer of Skin, Except Decubitus",0.113 HCC150 ,Extensive Third-Degree Burns,0.083 HCC154,Sever Head Injury,0.073 HCC155 ,Major Head Injury,0.04 HCC157 ,Vertebral Fractures without Spinal Cord Injury,0.046 HCC158 ,Hip Fracture/Dislocation,0.051 HCC161 ,Traumatic Amputation,0.093 HCC164 ,Major Complications of Medical Care and Trauma,0.027 HCC174 ,Major Organ Transplant Status,0.193 HCC176 ,Artificial Openings for Feeding or Elimination,0.071 HCC177,"Amputation Status, Lower Limb/Amputation Complications",0.093 Medicaid Interactions with Age and Sex,, Medicaid_female_aged ,,0.033 Medicaid_female_disabled,,0.052 Medicaid_male_aged ,,0.047 Medicaid_male_disabled ,,0.042 Originally Disabled Interactions With Sex,, "Female, 65+, Originally Entitled due to ESRD/ w or wo Disability",,-0.067 "Male, 65+, Originally Entitled due to ESRD/ w or wo Disability",,-0.049 "Female, 65+, Originally Entitled due to Disability (non-ESRD)",,0.052 "Male, 65+, Originally Entitled due to Disability (non-ESRD)",,0.023 Disabled/Disease Interactions,, D_HCC5 ,<65*Opportunistic Infections,0.092 D_HCC44 ,<65*Severe Hematological Disorders,0.07 D_HCC51 ,<65*Drug/Alcohol Psychosis,0.095 D_HCC52 ,<65*Drug/Alcohol Dependence,0.095 D_HCC107,<65*Cystic Fibrosis,0.181 [1] This model is used for those enrollees who have a full year of base year claims data.,, "[2] Mean Year 2000 Total Expenditures = $53,404.31. Mean is over all dialysis patients including those with Medicare as secondary payer.",,