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Richard M. Allman, MD
University of Alabama at Birmingham

JAMA. 1997;277(7):530-531.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—In the article by Dr Fowles and colleagues¹ comparing risk-adjustment methods for setting capitation rates, the authors conclude that risk adjustments based on diagnostic information available from administrative data or self-reported chronic conditions should be used rather than adjusting for functional status measures, such as the Medical Outcomes Study 36-Item Short-Form Functional and Perceived Health Status Survey (SF-36). However, their data demonstrate that such a functional status measure performs just as well, if not better, than diagnosis-based adjustments, particularly among high-risk persons older than 65 years. Adjustment using diagnosis-based ambulatory care groups predicted health care expenditures within 5% of actual expenses for 75% of the persons older than age 65 who were categorized as high risk. In contrast, SF-36-adjusted data were similarly accurate in 85% of the older high-risk persons.

The authors suggest a number of reasons for preferring administrative claims or encounter data for adjusting . . . [Full Text PDF of this Article]

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