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Q: How do I run CDPS or Medicaid Rx (MRX)?
A: Instructions for running CDPS are in the header of the cdps01.sas file. Instructions for running MRX are in the header of the mrx01.sas file. There is no additional documentation at this time.
Q. What is the difference between CDPS and MRX? What is CDPS+Rx? What is MRX-R?
A. CDPS is a diagnosis-based risk adjustment model that uses ICD codes to assess risk, while MRX is a pharmacy-based model that uses NDC codes to assess risk. CDPS+Rx is a combined diagnosis and pharmacy based model that employs both ICD9 and NDC codes. MRX-R creates the 15 MRX categories used in the combined CDPS+Rx model. Run MRX-R using mrx02.sas.
Q. Is there a separate file that needs to be downloaded that contains SAS code to create CDPS + Rx?
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A. Hands off 3 2 7. The text file CDPSMRX.txt includes SAS code to combine CDPS with MRX-R to create CDPS+Rx.
Q: What is the difference between version 5 and earlier versions?
A: Version 5 represents a substantial revision based on nationwide data from the Medicaid Analytic eXtract (MAX) data system.
Q. What is the difference between version 5.x and 6.0?
A. Version 5.x includes CDPS, MRX, and model weights; the CDPS code is based on ICD9 codes only. Version 6.0 includes only the CDPS code, and that version of CDPS can use both ICD9 and ICD10 codes. Version 6.0 no longer includes CDPS categories that do not have associated weights (e.g. SL, NWD, EXCL). If you want to use a 6.0 version of CDPS+Rx, you will need to use the CDPS code from 6.0 and the MRX-R code from 5.4. If you want to sue the CDPS or MRX weights, you will need to obtain these from version 5.x.
Q. What is the difference between versions 5.x?
A. Version 5.x includes CDPS, MRX, and model weights; the CDPS code is based on ICD9 codes only. Version 6.0 includes only the CDPS code, and that version of CDPS can use both ICD9 and ICD10 codes. Version 6.0 no longer includes CDPS categories that do not have associated weights (e.g. SL, NWD, EXCL). If you want to use a 6.0 version of CDPS+Rx, you will need to use the CDPS code from 6.0 and the MRX-R code from 5.4. If you want to sue the CDPS or MRX weights, you will need to obtain these from version 5.x
Q. How often are the models updated, and how do I find out about updates?
A. CDPS and MRX and typically updated on an annual basis with the most recent ICD9 and NDC codes. We notify everyone who has previously downloaded CDPS/MRX when a new version becomes available.
Q. How do I apply the weights?
A. You will need to write your own code to apply the weights.
Q. How do I obtain the weights and which weights should I use?
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A. The weights are provided in the excel files. Several set of weights are available. These include prospective and concurrent weights (PRO and CON), which predict future and current expenditures, respectively. If you do not know which to use, we recommend using prospective weights. Weights are also specific to a category of assistance: disabled adults and children (DADC), TANF adults (AA), and TANF children (AC). If you are using the models in a commercial population, we recommend using the TANF weights. Finally, four sets of weights are available depending on the set of services you are considering: the ACUTE weights were developed on the set of services typically included in a full acute care benefit package, the MH_CO weights have had mental health specialty services carved out (i.e. excluded), RX_CO has pharmaceuticals carved out, and MHRX_CO has both mental health and pharmaceutical services carved out.
Q. Is it possible to obtain a set of weights that is customized to my population?
A. Yes, we can most likely we create a customized weight set for a price that is conditional on the level of effort required for your specific application.
Q. I notice that not all of the CDPS categories created by the software have corresponding weights. Is this by design?
A. Yes, although we map all of the ICD9 codes to CDPS categories, several of the categories are not included when calculating the risk scores. These include categories with super low (SL) coefficients, categories that include diagnoses that are not well defined (NWD), and most of the V and E codes which are excluded (EXCL). There is also a set of categories that capture low birth-weight newborns (BABY). Although we have mapped low birth-weight diagnoses, we have never received a request to use them to adjust payments to health plans.
Q. I noticed that NDC codes are missing from the MRX code. Is this by design?
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A. Yes, although we map all of the ICD9 codes, we include in the MRX code only NDC codes that are mapped to paid categories.
Q. Is there user support?
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A. Unfortunately, since we provide our software for free, we have limited resources to provide user support. If you need extensive support, we can refer you to an actuarial consulting firm.
Q. Where should I go to learn more about CDPS or risk adjustment more generally?
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A. Please download and read our paper on CDPS available on this website.