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dc.contributor.authorAttridge, Mark
dc.date.accessioned2014-03-04T13:54:43Z
dc.date.available2014-03-04T13:54:43Z
dc.date.issued1998
dc.identifier.citationAttridge, M. (1998, June). Pareto group instability and the prediction of health care claims costs. Paper presented at the meeting of the American Psychological Society, Washington DC.en_US
dc.identifier.urihttp://hdl.handle.net/10713/3852
dc.descriptionFull-text academic style paper that describes an original research study based on a random sample of employees working for a state-wide government organization, which was the customer of the external EAP program vendor. The study uses survey data and matched two-years of health care claims data. 12 pages. 2 Tables. 4 References.en_US
dc.description.abstractAs the cost of health care has increased so have efforts to control costs. An assumption underlying many of these efforts is that health care costs can be predicted. A corollary assumption is that if costs can be predicted, then they can be managed. One fact used to support this approach is that a small group of people typically do create the vast majority of health care costs. The 20/80 rule indicates that within a given population, 20% of the people create 80% of the costs for a year period, with this high-cost subpopulation being called the “pareto group.” If one could predict who the pareto group will be, then the task of managing costs could be directed toward this smaller group rather than to all people in a health care system. This study investigated the stability of heath care costs using a methodology featuring a two-year longitudinal design, stratified random sampling, a large sample size (N = 974), claims system data and self-report survey data, and statistical testing. The typical “regression to the mean” effect was observed, as extreme cases (both high cost and low cost) moved toward the middle during the next year. Almost two-thirds of cases changed their claims cost group status from one year to the next year. The “pareto” group (top 20% of costs in the past year) was the most unstable, with less than 4% still classified at the same highest-cost level the following year. The most striking finding was that 92% of future claims costs could not be predicted, even when using past claims costs and relevant survey data on age, sex, health care visits and psycho-social concerns. Cost control implications of prevention, health promotion, and demand management services (such as employee assistance program counseling and education) are discussed.en_US
dc.description.sponsorshipOptum (a specialty division of United HealthCare Corporation)en_US
dc.description.tableofcontentsIntroduction. Method. Results. Conclusions. References.en_US
dc.language.isoen_USen_US
dc.subjectclaims dataen_US
dc.subjectPareto Groupen_US
dc.subject.lcshEmployee assistance programsen_US
dc.subject.lcshCosten_US
dc.subject.meshHealth Promotionen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSurveys and Questionnairesen_US
dc.titlePareto Group Instability and the Prediction of Health Care Claims Costsen_US
dc.typeReporten_US
dc.description.versionAmerican Psychological Societyen_US
dc.identifier.ispublishedNoen_US
dc.description.urinameFull Texten_US
refterms.dateFOA2019-02-20T16:57:48Z


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