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Upcoding: Evidence from Medicare on Squishy Risk Adjustment

In most US health insurance markets, plans face strong incentives to “upcode” the patient diagnoses they report to the regulator, as these affect the risk-adjusted payments plans receive. We show that enrollees in private Medicare plans generate 6% to 16% higher diagnosis-based risk scores than they...

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Detaylı Bibliyografya
Yayımlandı:J Polit Econ
Asıl Yazarlar: Geruso, Michael, Layton, Timothy
Materyal Türü: Artigo
Dil:Inglês
Baskı/Yayın Bilgisi: 2020
Konular:
Online Erişim:https://ncbi.nlm.nih.gov/pmc/articles/PMC7384673/
https://ncbi.nlm.nih.gov/pubmed/32719571
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1086/704756
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