Risk Score Specifications and Codebook for The Hilltop Institute’s Pre- Models, Version 1.1

Abstract

In 2014, the state of Maryland partnered with the Centers for Medicare and Medicaid Services (CMS) to modernize its unique all-payer rate-setting system for hospital services to improve the overall health of Maryland residents by increasing health care quality and reducing the cost of care. In service of providing better care at lower costs, The Hilltop Institute at UMBC, in partnership with the Maryland Department of Health, has developed predictive risk stratification models to identify patients at high risk for potentially preventable health care utilization that can be used to help target care resources to the patients who need them most.

This document strives to explain the intended use, technical implementation, and model performance of the Hilltop Pre- Models as of November 2022. The Pre- Models are a suite of prediction tools spanning the Pre-AH Model™, Pre-CH Model™, Pre-DC Model™, and Pre-HE Model™. This document will be updated as the models are updated or when new models become operational, and significant changes will be noted in the documentation edit history table and in the text when necessary. This first section of the codebook provides a short introduction; the second section provides a general overview of data sources, training methodology, and scoring methodology; the third section provides specific details on the performance and operations of each model within the Hilltop Pre- Models suite; and the fourth section presents limitations.