Variable,Disease Group,Community Factors,Institutional Factors Female 0-34 Years,,0.187,1.026 35-44 Years ,,0.206,0.884 45-54 Years ,,0.275,0.888 55-59 Years ,,0.333,0.943 60-64 Years ,,0.411,0.943 65-69 Years ,,0.299,0.971 70-74 Years ,,0.368,0.931 75-79 Years ,,0.457,0.835 80-84 Years ,,0.544,0.775 85-89 Years ,,0.637,0.704 90-94 Years ,,0.761,0.614 95 Years or Over ,,0.771,0.457 Male 0-34 Years ,,0.12,1.03 35-44 Years ,,0.164,0.871 45-54 Years ,,0.217,0.871 55-59 Years ,,0.249,0.978 60-64 Years ,,0.389,1.015 65-69 Years ,,0.328,1.221 70-74 Years ,,0.413,1.154 75-79 Years ,,0.517,1.143 80-84 Years ,,0.597,1.087 85-89 Years ,,0.692,1.001 90-94 Years ,,0.834,0.932 95 Years or Over ,,0.98,0.743 Medicaid and Originally Disabled Interactions with Age and Sex Medicaid_Female_Aged,,0.179,0.091 Medicaid_Female_Disabled,,0.131,0.091 Medicaid_Male_Aged,,0.166,0.091 Medicaid_Male_Disabled,,0.077,0.091 Originally Disabled_Female,,0.204,0.023 Originally Disabled_Male,,0.168,0.023 Disease Coefficients,Description Label HCC1,HIV/AIDS,0.945,0.967 HCC2,Septicemia/Shock,0.759,0.764 HCC5,Opportunistic Infections,0.3,0.288 HCC7,Metastatic Cancer and Acute Leukemia,2.276,0.824 HCC8,"Lung, Upper Digestive Tract, and Other Severe Cancers",1.053,0.47 HCC9,"Lymphatic, Head and Neck, Brain, and Other Major Cancers",0.794,0.368 HCC10,"Breast, Prostate, Colorectal and Other Cancers and Tumors",0.208,0.182 HCC15,Diabetes with Renal or Peripheral Circulatory Manifestation (1),0.508,0.459 HCC16,Diabetes with Neurologic or Other Specified Manifestation (1),0.408,0.459 HCC17,Diabetes with Acute Complications (1),0.339,0.459 HCC18,Diabetes with Ophthalmologic or Unspecified Manifestation (1),0.259,0.459 HCC19,Diabetes without Complication (1),0.162,0.248 HCC21,Protein-Calorie Malnutrition,0.856,0.374 HCC25,End-Stage Liver Disease,0.978,0.654 HCC26,Cirrhosis of Liver,0.406,0.384 HCC27,Chronic Hepatitis,0.406,0.384 HCC31,Intestinal Obstruction/Perforation,0.311,0.345 HCC32,Pancreatic Disease,0.403,0.309 HCC33,Inflammatory Bowel Disease,0.241,0.205 HCC37,Bone/Joint/Muscle Infections/Necrosis,0.535,0.497 HCC38,Rheumatoid Arthritis and Inflammatory Connective Tissue Disease,0.346,0.215 HCC44,Severe Hematological Disorders,1.015,0.493 HCC45,Disorders of Immunity,0.912,0.427 HCC51,Drug/Alcohol Psychosis (3),0.274,0 HCC52,Drug/Alcohol Dependence (3),0.274,0 HCC54,Schizophrenia,0.524,0.351 HCC55,"Major Depressive, Bipolar, and Paranoid Disorders",0.353,0.293 HCC67,"Quadriplegia, Other Extensive Paralysis",1.011,0.434 HCC68,Paraplegia,0.993,0.434 HCC69,Spinal Cord Disorders/Injuries,0.558,0.225 HCC70,Muscular Dystrophy (3),0.395,0 HCC71,Polyneuropathy,0.327,0.225 HCC72,Multiple Sclerosis,0.599,0.145 HCC73,Parkinson's and Huntington's Diseases,0.592,0.092 HCC74,Seizure Disorders and Convulsions,0.267,0.177 HCC75,"Coma, Brain Compression/Anoxic Damage (3)",0.415,0 HCC77,Respirator Dependence/Tracheostomy Status,1.867,1.559 HCC78,Respiratory Arrest,1.082,1.235 HCC79,Cardio-Respiratory Failure and Shock,0.578,0.445 HCC80,Congestive Heart Failure,0.41,0.228 HCC81,Acute Myocardial Infarction,0.359,0.424 HCC82,Unstable Angina and Other Acute Ischemic Heart Disease,0.284,0.424 HCC83,Angina Pectoris/Old Myocardial Infarction,0.244,0.29 HCC92,Specified Heart Arrhythmias,0.293,0.207 HCC95,Cerebral Hemorrhage,0.324,0.179 HCC96,Ischemic or Unspecified Stroke,0.265,0.179 HCC100,Hemiplegia/Hemiparesis,0.437,0.039 HCC101,Cerebral Palsy and Other Paralytic Syndromes (3),0.18,0 HCC104,Vascular Disease with Complications,0.61,0.482 HCC105,Vascular Disease,0.316,0.165 HCC107,Cystic Fibrosis,0.399,0.631 HCC108,Chronic Obstructive Pulmonary Disease,0.399,0.359 HCC111,Aspiration and Specified Bacterial Pneumonias,0.703,0.573 HCC112,"Pneumococcal Pneumonia, Emphysema, Lung Abscess",0.249,0.181 HCC119,Proliferative Diabetic Retinopathy and Vitreous Hemorrhage,0.252,0.497 HCC130,Dialysis Status,1.349,1.718 HCC131,Renal Failure,0.368,0.388 HCC132,Nephritis,0.125,0.253 HCC148,Decubitus Ulcer of Skin,1.153,0.485 HCC149,"Chronic Ulcer of Skin, Except Decubitus",0.449,0.241 HCC150,Extensive Third-Degree Burns (3),1.416,0 HCC154,Severe Head Injury (3),0.415,0 HCC155,Major Head Injury (3),0.106,0 HCC157,Vertebral Fractures without Spinal Cord Injury,0.443,0.161 HCC158,Hip Fracture/Dislocation (3),0.429,0 HCC161,Traumatic Amputation,0.678,0.26 HCC164,Major Complications of Medical Care and Trauma,0.296,0.309 HCC174,Major Organ Transplant Status,0.705,0.92 HCC176,Artificial Openings for Feeding or Elimination,0.662,0.841 HCC177,"Amputation Status, Lower Limb / Amputation Complications",0.678,0.26 Disabled/Disease Interactions D_HCC5,Disabled_Opportunistic Infections,0.623,1.016 D_HCC44,Disabled_Severe Hematological Disorders,1.036,0.362 D_HCC51,Disabled_Drug/Alcohol Psychosis ,0.729,0.299 D_HCC52,Disabled_Drug/Alcohol Dependence,0.31,0.299 D_HCC107,Disabled_Cystic Fibrosis (3),1.097,- Disease Interactions INT1,DM_CHF (2),0.154,0.125 INT2,DM_CVD,0.102,0.028 INT3,CHF_COPD,0.219,0.194 INT4,COPD_CVD_CAD,0.173,0.071 INT5,"RF_CHF (2,3)",0.231,- INT6,RF_CHF_DM (2),0.477,0.358 NOTES: (1) Includes Type I or Type II Diabetes Mellitus. "(2) Beneficiaries with the three-way interaction RF*CHF*DM are excluded from the two-way interactions DM*CHF and RF*CHF. Thus, the three-way interaction term RF*CHF*DM is not additive to the two-way interaction terms DM*CHF and RF*CHF. Rather, it is hierarchical to, and excludes these interaction terms. A beneficiary with all three conditions is not ""credited"" with the two-way interactions. All other interaction terms are additive." (3) HCC or disease interaction excluded from institutional model because estimated coefficient less than 0 or t-statistic less than 1.0. "The 2007 denominator of $7,463.14 used to calculate both the community and institutional factors is the national predicted average annual cost under the model." DM is diabetes mellitus (HCCs 15-19). CHF is congestive heart failure (HCC 80). COPD is chronic obstructive pulmonary disease (HCC 108). "CVD is cerebrovascular disease (HCCs 95, 96, 100, and 101)." CAD is coronary artery disease (HCCs 81-83). RF is renal failure (HCC 131). SOURCE: RTI International analysis of 2004/2005 Medicare 5% sample. SOURCE: RTI International analysis of 2004/2005 Medicare 100% institutional sample.