CORPORATE MEDICAL CLAIM COST DISTRIBUTIONS AND FACTORS ASSOCIATED WITH HIGH-COST STATUS

Medical claims cost distributions and factors that relate to these cos ts were studied among 7796 employees who selected an indemnity medical plan for at least one year during 1985 to 1990. Descriptions for medi cal claims costs were presented for both single- and multiple-year tim e periods. Factors that associated with high cost status were studied by using multiple logistic regression models. Employees at or above th e top tenth cost percentile were accounted for approximately 80%, 65%, and 58% of the total employees' medical costs to the employer in sing le-year, 3-year, and 6-year periods, respectively. Bivariate analyses indicated that six of the seven selected demographic variables were si gnificantly related to cost status. When the multivariate models exclu ded health risk measures, four of the demographic variables and the fr equency of health risk appraisal completion were significantly associa ted with cost status. When the multivariate models included health ris k measures, the health risk measures became the dominant predictors of the high-cost status.