Primary care practices’ ability to predict future risk of expenditures and hospitalization using risk stratification and segmentation

Table 2 Selected diagnostic characteristics of practice-derived scores and HCC scores versus expenditure and utilization outcomes (N = 3,381)

Outcome	Practice: high risk	HCC: high risk	Δ (Practice-HCC)
Outcome	Average (range)	Average (range)	Δ (Practice-HCC)
ED ≥ 2 (12%)
Sensitivity	0.3 (0.14, 0.69)	0.32 (0.17, 0.6)	− 0.02
PPV	0.25 (0.15, 0.33)	0.28 (0.23, 0.33)	− 0.03
Accuracy	0.76 (0.57, 0.87)	0.76 (0.53, 0.87)	0.00
Hospitalization ≥ 1 (14%)
Sensitivity	0.26 (0.1, 0.53)	0.36 (0.16, 0.6)	− 0.10**
PPV	0.24 (0.15, 0.33)	0.34 (0.27, 0.5)	− 0.10**
Accuracy	0.74 (0.51, 0.84)	0.77 (0.54, 0.86)	− 0.03
Expenditures ≥ 30k (9%)
Sensitivity	0.26 (0.07, 0.54)	0.4 (0.22, 0.66)	− 0.14**
PPV	0.16 (0.06, 0.32)	0.24 (0.19, 0.32)	− 0.08**
Accuracy	0.77 (0.51, 0.88)	0.79 (0.55, 0.9)	− 0.02

ED = Emergency Department use; PPV = Positive Predictive Value, or (True Positives)/(True Positives + False Positives); Sensitivity = True Positives/(True Positives + False Negatives); Accuracy = (True Positives + True Negatives)/All Cases; 30k = 30,000; HCC = Hierarchical Condition Category score
^*p value < .05; **p value < .01; ***p value < .001

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