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Upcoding Linked To Up To Two-Thirds Of Growth In Highest-Intensity Hospital Discharges In 5 States, 2011-19.
Health Aff (Millwood)
December 2024
Christopher M. Whaley, Brown University, Providence, Rhode Island.
Diagnosis-based payment systems can create incentives to upcode patients to a higher level of severity to increase payment. In some instances, upcoding can be a form of fraud if providers code patients to a higher complexity than is appropriate, whereas in other instances, upcoding can accurately reflect patient acuity. We estimated the increase in Medicare Severity Diagnosis-Related Group (MS-DRG) upcoding during the period 2011-19, using all-payer discharge-level data from five states.
View Article and Find Full Text PDFLimitations of the inotrope score use as a measure of primary graft dysfunction.
J Heart Lung Transplant
October 2024
Department of Cardiothoracic Surgery and Transplantation, The Alfred, Melbourne, Australia; Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia; Critical Care Research Group, The Prince Charles Hospital, Brisbane, Australia.
Allograft dysfunction is the major cause of early morbidity and mortality following cardiac transplantation. Poor graft function can be secondary to transplant complications or, when no identifiable cause is present, primary graft dysfunction (PGD). To standardize the definition of PGD, a consensus conference was convened which produced a document that defines severity categories and criteria for assessing left and right ventricular dysfunction.
View Article and Find Full Text PDFRequesting That Delirium Achieve Parity With Acute Encephalopathy in the MS-DRG System.
J Acad Consult Liaison Psychiatry
June 2024
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Since 2007, the Medicare Severity Diagnosis Related Groups classification system has favored billing codes for acute encephalopathy over delirium codes in determining hospital reimbursement and several quality-of-care value metrics, despite broad overlap between these sets of diagnostic codes. Toxic and metabolic encephalopathy codes are designated as major complication or comorbidity, whereas causally specified delirium codes are designated as complication or comorbidity and thus associated with a lower reimbursement and lesser impact on value metrics. The authors led a submission to the U.
View Article and Find Full Text PDFMedicare's Hospital Readmission Reduction Program reduced fall-related health care use: An unexpected benefit?
Health Serv Res
February 2024
Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.
Objective: To assess whether Medicare's Hospital Readmissions Reduction Program (HRRP) was associated with a reduction in severe fall-related injuries (FRIs).
Data Sources And Study Setting: Secondary data from Medicare were used.
Study Design: Using an event study design, among older (≥65) Medicare fee-for-service beneficiaries, we assessed changes in 30- and 90-day FRI readmissions before and after HRRP's announcement (April 2010) and implementation (October 2012) for conditions targeted by the HRRP (acute myocardial infarction [AMI], congestive heart failure [CHF], and pneumonia) versus "non-targeted" (gastrointestinal) conditions.
Incidence of moral hazards among health care providers in the implementation of social health insurance toward universal health coverage: evidence from rural province hospitals in Indonesia.
Front Public Health
September 2023
Faculty of Medicine, Andalas University, Padang, Indonesia.
Objective: To identify the incidence of moral hazards among health care providers and its determinant factors in the implementation of national health insurance in Indonesia.
Methods: Data were derived from 360 inpatient medical records from six types C public and private hospitals in an Indonesian rural province. These data were accumulated from inpatient medical records from four major disciplines: medicine, surgery, obstetrics and gynecology, and pediatrics.
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