Chapter 8: Measuring Costs to Medicare

Introduction and Goals

Review and Approach

Review: Basics of Medicare Cost

Our Programming Plan

A Note on Payment Standardization and Risk Adjustment

Algorithms: Measuring Evaluation and Management Payments

Algorithms: Measuring Inpatient Hospital Payments

Algorithms: Measuring Total Part A Payments

Chapter Summary

Exercises

 

Introduction and Goals

Measuring cost is important because it gets to the heart of the sustainability of any insurance program, and Medicare is certainly no exception. It is no understatement to say that the measurement of cost in the Medicare program is a hot topic. Open any newspaper or magazine or turn on the evening news and you will see that reducing cost without negatively ...

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