Estimating Payment Error for Medicare Acute Care Inpatient Services

نویسندگان

  • W. Mark Krushat
  • Anita J. Bhatia
چکیده

CMS recently assumed responsibility for estimating the Medicare fee-for-service (FFS) error rate from the Office of the Inspector General (OIG). Here, the method used to calculate national, by State, and by error type, estimates for the inpatient acute care portion of this rate is presented. For fiscal years (FYs) 1998 and 2000 discharges, national estimates for the net error rate were 2.6 and 2.8 percent, respectively, about $2 billion annually. Wide variation in State rates illustrates that estimates to the State level are essential for targeting and monitoring interventions to reduce improper Medicare inpatient acute care reimbursements.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Lessons learned preparing for Medicare bundled payments.

n engl j med 367;20 nejm.org november 15, 2012 1873 for coordinating care across the continuum of services. These systems support a fragmented delivery system at substantial cost to taxpayers and Medicare beneficiaries. Policy analysts have long been interested in encouraging improved efficiency and care coordination by bundling Medicare payments for a range of services delivered during defined...

متن کامل

Overview: Medicare Post-Acute Care Since the Balanced Budget Act of 1997

contained the most sweeping changes in payment policy for Medicare post-acute care (PAC) services ever enacted in a single piece of legislation. Research on the early impacts of these changes is now beginning to appear, and this issue of the Health Care Financing Review includes six articles covering a range of timely PAC issues. There are two articles on skilled nursing facility (SNF) care—the...

متن کامل

Shrinking inpatient psychiatric capacity: cause for celebration or concern?

This issue brief examines reported capacity constraints in inpatient psychiatric services and describes how these services fit within the continuum of care for mental health treatment. The paper summarizes the type and range of acute care services used to intervene in mental health crises, including both traditional hospital-based services and alternative crisis interventions, such as mobile re...

متن کامل

Report to Congress Prospective Payment System for Inpatient Services in Psychiatric Hospitals and Exempt Units

Historically, Medicare reimbursed health care facilities on the basis of costs. Cost based reimbursement methods have long been criticized because they are often complex, provide few incentives for furnishing care efficiently, and result in unpredictable payments. Because of the rapid rate of growth in outlays for inpatient hospital care, Congress first directed implementation of a prospective ...

متن کامل

Use and cost of short-stay hospital inpatient services under Medicare, 1988

In this article, data are presented on trends in the use of and program payments for inpatient short-stay hospital services to Medicare beneficiaries. The data on the services used by aged and disabled Medicare beneficiaries are presented for the years 1972 through 1988. The discussion is focused on trends in utilization and program payments resulting from the implementation of the Medicare pro...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 26  شماره 

صفحات  -

تاریخ انتشار 2005