Dataset Identification:
Resource Abstract:
- <p>In 2004, Medicare implemented a risk-adjustment system that pays Medicare Advantage (MA) plans based on diagnoses reported
for their enrollees, giving the plans an incentive to identify more diagnoses. As reported in the article, Measuring Coding
Intensity in the Medicare Advantage Program, published in Volume 4, Issue 2 of Medicare and Medicaid Research Review, each
year since 2004 the average MA risk score increased faster than the average fee-for-service (FFS) score. This relative increase
in scores largely reflects changes in diagnostic coding, not real increases in the morbidity of MA enrollees, as survey-based
data shows no trend in MA risk scores relative to FFS scores. Increases in risk scores vary widely by MA contract, with some
contracts coding very similarly to traditional Medicare and others more intensively than the MA average.</p>
Citation
- Title Measuring Coding Intensity in Medicare Advantage - SUPP.
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- revision Date
2014-10-28
Theme keywords (theme):
Coding and Coding Rules
Hospital Referral Region
Medicare Advantage
Resource language:
[u'en']
Constraints on resource usage:
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- Constraints
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- Use limitation statement:
- public
point of contact
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publisher
- individual Name {u'hasEmail': u'mailto:HealthData@hhs.gov', u'fn': u'Health Data Initiative'}
- organisation Name
{u'@type': u'org:Organization', u'name': u'Centers for Medicare & Medicaid Services'}
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- Contact information
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- Address
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- electronic Mail Address
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Metadata data stamp:
2014-10-28
Metadata contact
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publisher
Metadata scope code
dataset
Metadata standard for this record:
ISO 19115:2003 - Geographic information - Metadata
standard version:
ISO 19115:2003
Metadata record identifier:
520
Metadata record format is ISO19139 XML (MD_Metadata)