Becker’s Hospital Review summarized a recently released report from The Wall Street Journal that found Medicare Advantage plans collected $50 billion from diagnoses added to patients’ charts between 2018 and 2021, a third of which were added during home visits – even as the Medicare Payment and Advisory Commission recommends against insurers being paid for diagnoses added through home visits.
From the article:
By Rylee Wilson
Insurers made billions from diagnoses added to Medicare Advantage beneficiaries’ charts during home visits, The Wall Street Journal found in an investigation published Aug. 5.
Previous reporting from the Journal found that MA insurers made $50 billion from diagnoses added to patients charts between 2018 and 2021. Many of these diagnoses were “questionable,” according to the Journal.
Around a third of these diagnoses were added during home visits, the Journal reported. The federal government pays Medicare Advantage plans a rate per beneficiary based on their diagnoses.
The federal government will spend $83 billion more on Medicare Advantage beneficiaries than if they were enrolled in fee-for-service Medicare, according to estimates from the Medicare Payment and Advisory Commission. Coding intensity in MA will be 20% higher than in fee-for-service in 2024, according to the commission, which advises the federal government on Medicare issues.
See what else Groundswell Health is working on in healthcare >>
Gripping Fear Before it Grips you Back
What we can learn from the Empowered by Parkinson's documentary in this time of COVID-19 It's easy to let fear
Communications in Crisis: Tips from Groundswell Health
Let's just take a minute here to remember one thing: Hospitals have been in transformation mode for more than a
Doubling Down on Content Marketing in Times of Uncertainty
With hospital leaders laser focused on caring for their communities as the COVID-19 pandemic takes hold, they have little to
Taming Our Inner Veruca Salt
Remember Veruca Salt from Willy Wonka and the Chocolate Factory? She was the spoiled little girl who wanted what she