Threat Adjustment and Incentives for Upcoding in Medicare – Healthcare Economist

[ad_1] To account for variations in illness burden throughout a Medicare Benefit (MA) plans affected person inhabitants, makes use of danger adjustment primarily based on affected person illness burden. Particularly, MedPAC notes that: Medicare makes use of beneficiaries’ traits, resembling age and prior well being situations, and a risk-adjustment mannequin—the CMS hierarchical situation classes (CMS– […]