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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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| Publicat a: | J Polit Econ |
|---|---|
| Autors principals: | , |
| Format: | Artigo |
| Idioma: | Inglês |
| Publicat: |
2020
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| Matèries: | |
| Accés en línia: | 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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