CDPS


Bookmark and Share


The Chronic Illness and Disability Payment System (CDPS) is a diagnostic classification system that Medicaid programs can use to make health-based capitated payments for TANF and disabled Medicaid beneficiaries. The CDPS code is provided under license and free of charge to qualified public agencies, educational institutions, and researchers.

Click here for a brief report in PDF format entitled The Revision of CDPS and the Development of a Combined Diagnostic and Pharmacy Based Risk Adjustment Model





We are pleased to announce the release of revised versions of the Chronic Illness and Disability Payment System (CDPS) and the Medicaid Rx (MRX) risk adjustment models, as well as a new, combined diagnosis and pharmacy based risk adjustment model, CDPS + Rx. These new models (Version 5.0) are based on analyses of data from 44 state Medicaid programs, 2001-2002. The update of CDPS involved the reassignment of over 4,000 ICD9 codes and the revision of several major categories. The new CDPS + Rx model includes 15 MRX categories that identify a large number of Medicaid beneficiaries who receive pharmacotherapy but not an ICD9 diagnosis.

Click here for a detailed description of CDPS from the Spring 2000 issue of the Health Care Financing Review (requires Adobe Acrobat or Acrobat Reader).

Synopsis: The authors describe the diversity of diagnoses and different burdens of illness among disabled and AFDC Medicaid beneficiaries. Claims from seven states were analyzed which provided payment weights that states can use when adjusting HMO payments. The taxonomy and statistical performance of CDPS were compared to other leading diagnostic classification systems, and the findings suggest that the new model performs better in a number of respects.

Also available: CDPS-Medicare:The Chronic Illness and Disability Payment System Modified to Predict Expenditures for Medicare Beneficiaries | Appendices

Synopsis: The Chronic Illness and Disability Payment System (CDPS) was originally developed for states to use in adjusting capitated payments for Medicaid beneficiaries. This report presents our work to revise CDPS for use in adjusting capitated Medicare payments to health plans. We describe the development of the original CDPS model and its modification to create the CDPS-Medicare model, and provide regression results for six variants of CDPS-Medicare. We examine the prediction of expenditures for various subsets of beneficiaries, including diagnostically defined groups, functionally impaired beneficiaries and institutionalized beneficiaries. The report also compares CDPS-Medicare with the Hierarchical Condition Category (HCC) model. Finally, we analyze the effects of mortality on HMO resource needs and analyze how changes in disease burden will affect imple-mentation of diagnosis-based payment.

Copyright © 2012 Regents of the University of California. All Rights Reserved. Major funding for this project provided by the Robert Wood Johnson Foundation and the Pew Charitable Trusts.