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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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Publicat a:Med Care
Autors principals: Meyers, David J, Trivedi, Amal N
Format: Artigo
Idioma:Inglês
Publicat: 2021
Matèries:
Accés en línia: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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