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 >>
Precision Marketing in Healthcare: Driving Smarter Outreach with Groundswell Health’s Agile Communications
In today’s hyper-connected, data-rich environment, healthcare marketing must be more than just broad messaging — it must be precise,
Atomizing Content: A Contemporary Tactic Vital to Healthcare Marketing
Creating engaging and relevant content is crucial, but an added advantage is utilizing a crew of advanced communications and marketing
Integrated Marketing Campaign | Meeting the Community’s Care Needs
Telemedicine's explosive growth during the COVID-19 pandemic brought attention to the opportunity pioneered by Access TeleCare leaders, but it also resulted in additional complexity to clarify the difference in specialty telemedicine serving health systems and outpatient clinics. Groundswell Health set out to highlight how access to specialists in a rural Arkansas community resulted in a huge opportunity for their citizens.
‘Going Beyond Traditional Rural Care’ Telemedicine Campaign | Access TeleCare
Category: Telemedicine Series Client: Access TeleCare A rural Texas hospital was struggling to provide specialty care for their patients
Medicare Advantage Headlines >>
Kaiser Family Foundation summary of Medicare Advantage trends and updates in 2024
The Kaiser Family Foundation summarized Medicare Advantage 2024 trends and updates in enrollment. Here are the main points: Enrollment
Humana tinkers with Medicare Advantage plans amid higher costs
As more seniors advance into Medicare eligibility, Humana noted decreases in its Medicare Advantage population leading to new consideration
