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Table 1 Characteristics of Heart Failure Cohorts in 2017

From: Challenges in predicting future high-cost patients for care management interventions

 

Segment 1

Segment 2

Segment 3

Number

3,639,259

1,897,108

1,025,745

Mean Age

77

78

77

Sex (Female)

54%

53%

54%

Eligibility Category

   

-Disabled (%)

25%

25%

26%

-Aged dually eligible for Medicaid and Medicare (%)

14%

15%

15%

-Aged, non-dual (%)

61%

60%

58%

ACO Status (%)

31%

31%

32%

Mortality 2018 (%)

13%

17%

21%

Mean PMPY 2017 (Truncated)

$22,947 ($29,444)

$30,968 ($34,255)

$46,440 ($35,467)

Mean PMPY 2018 (Truncated) (STD)

$18,391 ($27,335)

$21,689 ($30,495)

$27,037 ($35,322)

Zero Admissions 2018 (%)

67.5%

62.2%

53.6%

  1. Segment 1: Beneficiaries with at least one ambulatory (Part B) bill or an inpatient (Part A) with a heart failure ICD-10 diagnosis code
  2. Segment 2: Beneficiaries with at least two ambulatory (Part B) heart failure bills 30-days apart or one hospitalization with a primary diagnosis of heart failure
  3. Segment 3: Beneficiaries with one or more hospitalization with a primary diagnosis of heart failure