Recent studies document a substantial increase in emergency department (ED) spending in the past decade, even though the number of ED visits per capita has remained relatively stable. Price increases ...
A recent report from the HHS Office of the Inspector General (OIG) turned heads across the healthcare industry after pointing to a notable rise in inpatient hospital stays where upcoding was believed ...
Andrew S. Oseran, MD, MBA, MSc, hypothesizes that higher Medicare Advantage (MA) risk scores may result from either a more accurate capture of beneficiaries' comorbidities or inappropriate "upcoding" ...
At the start of 2023, an estimated 2.5 million Americans age 65 and older began using Medicare Advantage programs. Some made this choice in response to aggressive marketing campaigns. This brings the ...
This research seeks to determine if there is evidence of upcoding within primary care. We use Danish general practitioners (GPs) as a case study and investigate upcoding of home visits. We find that ...
Shifting from reducing MA capitation by an across-the-board coding intensity adjustment factor to Medicare Advantage organization (MAO)-specific adjustment factors would improve the financial outlook ...
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