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Pediatric Medical Cost Model
2007
The Pediatric Medical Cost Model allows practices to calculate state and locale-specific costs for each medical service recommended in the AAP "Scope of Health Care Benefits for Children From Birth Through Age 21" policy statement. Two previous versions of the model have supported AAP efforts in public and private payer advocacy. The current release has an enhanced capability to estimate utilization more precisely, which provides pediatric practices with a versatile tool to benchmark the cost to provide care for specific benefit packages or patient populations. While simple to use, the Pediatric Medical Cost Model allows for a wide range of applications. Users can model national or state average per-member-per-month (PMPM) medical cost for Medicaid/State Children's Health Insurance Program (SCHIP) or commercial plans covering all AAP-recommended benefits. Alternatively, users can customize model parameters to estimate benefit-specific PMPM at any level of co-pay or co-insurance, and for any patient age/gender mix in either rural or urban areas in any single state. This model was commissioned by the Academy and developed by the actuarial firm of Reden & Anders Inc. It includes a user agreement. The pediatric medical cost model can be accessed by going to http://www.aap.org/research/pedmedcostmodel.cfm. |
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The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care.
Variations, taking into account individual circumstances, may be appropriate. This content is for informational purposes only. It is not intended to
constitute financial or legal advice. A financial advisor or attorney should be consulted if financial or legal advice is desired.
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