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Table 2 Beneficiary counts and outcome measures for all Medicare ACO Assignment-Eligible Beneficiaries and for Three Heart Failure Segments in 2018

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

2018 Beneficiaries from 2017 Cohort

Number of Beneficiaries

Total Hospital Stays

Hospital Stays per 1,000 Beneficiaries

Number of Beneficiaries with Zero Hospital Stays

Percent Zero Hospital Stays

All Fee-for-service Beneficiaries

25,587,927

6,138,763

240

21,531,217

84%

Heart failure segment 1

3,160,002

1,859,564

588

2,133,143

68%

Heart failure segment 2

1,580,272

1,157,220

732

982,843

62%

Heart failure segment 3

810,045

795,952

983

433,912

54%

  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