Expansion and Updating of the Standardized Relative Resource Use Costing Model

The VDW provides researchers with data that have been cleaned, collapsed where appropriate, and consistently categorized by utilization type consistently across all CRN sites. While the VDW contains a tremendous amount of data, it is missing a vital element—costs of medical care. The addition of these data would greatly increase the number of studies investigators could conduct using VDW data. This project will expand the CRN’s VDW to include standardized costs for vast majority of services provided at all HMORN sites. This work represents a critical step in the network’s capacity to conduct clinical, behavioral and health services research. Standardized costs will allow us to gather inexpensive and internally and externally valid multi-site cost data for use in health services and economic analyses. Relative resource intensity weighting schemes will allow researchers to combine different utilization types into one common metric and provide a measure of overall health care resource intensity. This work is necessary because we must update the hospital and medical office visits and services algorithms so that they reflect recent changes in both the VDW and in external diagnosis and procedure coding systems. The medical office visits and services algorithm constructs costs using CPT-4 procedure codes, based on data from version 2 of the VDW, which did not contain CPT-4 modifier codes. Version 3 of the VDW contains modifier codes. Our study will incorporate the information contained in modifiers into the costing algorithm that will allow researchers to quantify important cost/intensity differences across outpatient clinic visits that they have previously been unable to detect. This project will enhance the activities of the CRN Health Care Quality and Cost (HCQC) Scientific Work Group (SWG).

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