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Table 4 Vermont Blueprint for Health Practice-Level Comparison of Mean Total Expenditures Excluding Special Medicaid Services (SMS) – No Adjustment vs. Full Model, CY2014

From: Risk-adjustment methods for all-payer comparative performance reporting in Vermont

Total Expenditures Excluding Special Medicaid Services (SMS) –Quintiles Adult Practices (N = 102) Pediatric Practices (N = 56)
No-Adjustment Mean Full-Model Mean No-Adjustment Mean Full-Model Mean
1 $5555 $5812 $1301 $1415
2 $6464 $6424 $1454 $1517
3 $7093 $6823 $1578 $1596
4 $7886 $7189 $1738 $1664
5 $9179 $8101 $1949 $1825
  1. For adult practices, compared to the no-adjustment model, the full model changed the quintile for 79 (77%) of the practices, with 41 practices shifting to a higher expenditure quintile and 38 changing to a lower expenditure quintile (23 remained in the same quintile). For pediatric practices, compared to the No-Adjustment Model, the Full Model changed the quintile for 30 (54%) of the practices, with 16 practices moving to a higher expenditure quintile and 14 changing to a lower expenditure quintile (26 remained in the same quintile). Examples of special Medicaid services include patients receiving day treatment, residential treatment, case management services, and special school services covered by the Department of Education