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Predictive Modeling: A Guide for State Medicaid Purchasers


This guide for care managers and State Medicaid agencies provides information on how to use predictive modeling tools to identify patients who are good candidates for care management. A list of key considerations can help States prioritize and effectively target populations for care management, and help guide decisionmaking for patient care. The guide helps agencies do the following:
  • Understand which features of a predictive model are critical as well as how to enhance information that is derived from predictive models for Medicaid populations
  • Address planning questions to guide the implementation of predictive modeling
  • Outline key considerations for choosing a predictive modeling tool to identify candidates for care management

Links to the Tool:
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Center for Health Care Strategies, Inc.

Funding Sources

Aetna Foundation; Kaiser Permanente

QualityTool Topic



  • Release Date: 08/2009
  • Original Summary: 01/2014
Disclaimer: The inclusion of a tool in the Innovations Exchange does not constitute or imply an endorsement by the U.S. Department of Health and Human Services, the Agency for Healthcare Research and Quality or Westat of the tool or of the submitter or developer of the tool. Read more.
QualityTool Classification
Patient Population:
Patient Care Process:
IOM Domains of Quality:

Last updated: January 29, 2014.