QualityMetric measurement scientists developed the SF Expenditure Prediction™ Solution to enhance the predictive
capability of payers and providers using SF health status information. Key benefits of the SF Expenditure Prediction Solution include:
- Prediction of average monthly medical expenditures for patients and populations based on current health status
- Improvement in the identification of members/patients at risk of incurring high future medical costs
- Provision of health status information to organizations, thus enabling informed economic decisions to be made on preventive care, and/or behavior modification
For Managed Care and Healthcare Delivery Organizations, Health Insurance Companies, and Self-Insured Employers Interested in Enhancing Predictive Capability and
Quality Improvement
QualityMetric's SF Expenditure Prediction Solution is a powerful enhancement to the interpretation value of patient-reported measures of health status.
An advantage of the SF Expenditure Prediction Solution over other sophisticated predictive modeling systems is that it is not necessary to have
claims data, which can be cumbersome to collect and in many instances, is not available for all members/patients.
For pharmaceutical, Biotechnology, and Medical Device Companies or CRO's Involved in Developing and Evaluating New Therapeutics
For breakthrough treatments to obtain formulary positioning with key payers, companies must demonstrate improved outcomes and cost-benefits.
Utilizing the SF Expenditure Prediction Solution in the development of proposed treatments can demonstrate improved predictions of medical expenditure
in treatment and placebo samples, gaining compelling pharmacoeconomic evidence.
QualityMetric's SF Expenditure Prediction Solution enables new interpretation of SF-36 and SF-12 Health Surveys based on newly developed,
scientifically valid algorithms. In a recent study (see below), the summary scores of the SF-12 improved the prediction of expenditures over
and above some of the variables traditionally used to predict expenditures, such as historical claims data, diagnoses, and demographics.
The SF Expenditure Prediction Solution is based on data collected from either Version 1 or Version 2 of the SF-36 or SF-12, administered
with paper and pencil or online, and available with either of two provider reports:
- The "standard" report offers real-time medical expenditure prediction on a per patient basis, derived from SF-36 or SF-12
scores combined with age and gender information.
- The "expanded" report presents medical expenditure prediction with patient stratification, based on the addition of age and gender information along with a Chronic Conditions Checklist.
The expanded report also provides benchmarking by disease.
Two additional features of the SF Expenditure Prediction Solution include a corresponding health status report, minus the predictive expenditure
information, for the member/patient as well as secure provider access to aggregate level data in real-time.
The SF Expenditure Prediction Solution is a valuable asset to payers and providers of any size or level of analytic capability,
with QualityMetric health outcomes measurement experts available for consultation on all aspects of study design, data scoring,
analysis and interpretation, and presentation of findings.
Related Information
Case Studies
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References to Papers Documenting the Development and Evaluation of Algorithms to Predict Medical Expenditures from SF Generic Health Survey Scores:
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