I have a question regarding the proper bootstrapping technique to use with data where strong clustering is present.
I've been tasked with evaluating a multivariate mixed effects predictive model on insurance claims data by scoring the current baseline model on more recent claims data, in order to determine how well the model predicts which episodes of care contain the highest frequency of sessions (upper 95th percentile). Sensitivity, specificity, and positive predictive value (PPV) will be used to assess the model effectiveness.
Bootstrapping seems the right way to go for building confidence intervals for the sensitivity, specificity, and PPV percentages. Unfortunately, a naive bootstrap is not appropriate given that the claims data is 1) correlated by care provider, 2) grouped into episodes of care with more frequent visits during months earlier in the episode of care (so some autocorrelation is present). Would a variation on the moving blocks bootstrap technique be appropriate here?
Or perhaps a three-step bootstrap procedure would work: 1) sample with replacement from the distinct providers in the data, then 2) sample with replacement from distinct episodes of care by selected providers, then 3) sample with replacement from distinct claims within each selected episode.
Many thanks for any suggestions!