The effects of coding intensity in Medicare Advantage on plan benefits and finances.
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DOI: 10.1111/1475-6773.13591
Abstract: OBJECTIVE To assess how beneficiary premiums, expected out-of-pocket costs, and plan finances in the Medicare Advantage (MA) market are related to coding intensity. DATA SOURCES/STUDY SETTING MA plan characteristics and administrative records from the Centers… read more here.
Keywords: plan benefits; medicare advantage; coding intensity; intensity ... See more keywords
Diagnostic Coding Intensity among a Pneumonia Inpatient Cohort Using a Risk-Adjustment Model and Claims Data: A U.S. Population-Based Study
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DOI: 10.3390/diagnostics12061495
Abstract: Hospital payments depend on the Medicare Severity Diagnosis-Related Group’s estimated cost and the set of diagnoses identified during inpatient stays. However, over-coding and under-coding diagnoses can occur for different reasons, leading to financial and clinical… read more here.
Keywords: diagnostic coding; coding intensity; level; risk ... See more keywords
Modeling Coding Intensity of Procedures in a U.S. Population-Based Hip/Knee Arthroplasty Inpatient Cohort Adjusting for Patient- and Facility-Level Characteristics
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DOI: 10.3390/healthcare10081368
Abstract: Variations in procedure coding intensity, defined as excess coding of procedures versus industry (instead of clinical) standards, can result in differentials in quality of care for patients and have additional implications for facilities and payors.… read more here.
Keywords: level characteristics; coding intensity; facility; level ... See more keywords