Bootstrap analysis (bootstrapping), as used in risk adjustment models, generally refers to estimating properties of a model estimate or the stability of an estimate by sampling from an approximating distribution. The measure developer may accomplish this by constructing many resamples of equal size from the observed dataset (e.g., the development sample), when the resamples are smaller than the observed dataset. This technique allows estimation of the sample distribution of a statistic. Measure developers can also use it to construct hypothesis tests. In the case of a regression or logistic regression risk adjustment model, the measure developer can use it to provide additional guidance regarding the inclusion of risk factors in the model.
A business case is a justification for a proposed project or undertaking on the basis of its expected commercial benefit. It exists if the entity realizes a financial return on its investment in a reasonable time frame. The entity may realize as profit, reduction in losses, or avoided costs. A business case may also exist if the investor believes that a positive indirect effect on organizational function and sustainability will accrue within a reasonable time frame (Leatherman et al., 2003). The business case for a process measure relies on the financial return on the investment necessary to implement the intervention advocated by the measure. The business case for other types of measures relies on the financial return resulting from improving the quality of care indicated by the measure.