Medicare Index Consumption-Cluster Method

The National Minority Quality Forum collected data retrospectively from the Medicare records to construct an annual cost profile for each Medicare fee-for-service beneficiary for the years 2000 through 2007.  It used a unique beneficiary identifier to link the Beneficiary Annual Summary Files to Medicare’s Chronic Condition Data Warehouse flags, which identified beneficiaries who received Medicare reimbursements for twenty chronic diseases. On the basis of their annual cost profiles, beneficiaries were grouped into one of five consumption clusters:

1. Crisis consumers (beneficiaries accounting for the 99th percentile [top 1%] of aggregate Medicare payments)

2. Heavy consumers (90th through 98th percentiles)

3. Moderate consumers (75th through 89th percentiles)

4. Light consumers (50th through 74th percentiles)

5. Low consumers (1st through 49th percentiles)


© 2011–2016 National Minority Quality Forum, Inc. All Rights Reserved.