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Medicare Advantage Chart Reviews Are Associated with Billions in Additional Payments for Some Plans

BACKGROUND: In the Medicare Advantage (MA) program, private plans receive capitated payments that are adjusted based on their enrollees’ number and type of clinical conditions. Plans have the ability to review charts to identify additional conditions that are not present in claims data, thereby incr...

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Detalhes bibliográficos
Publicado no:Med Care
Main Authors: Meyers, David J, Trivedi, Amal N
Formato: Artigo
Idioma:Inglês
Publicado em: 2021
Assuntos:
Acesso em linha:https://ncbi.nlm.nih.gov/pmc/articles/PMC7855237/
https://ncbi.nlm.nih.gov/pubmed/32925467
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.1097/MLR.0000000000001412
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