Post by arfanho7 on Feb 28, 2024 4:01:26 GMT -6
In a working paper coauthored with Ranjani Krishnan and Frank Moers titled Regulator Leniency and Mispricing in Beneficent Nonprofits Heese analyzed data during the period of to for nonprofit hospitals in California—before the ACA came into effect. Looking at three categories of diagnosis that are particularly prone to upcoding he estimated the extent of potential overstatement based on the hospitals detailed patient records.
Controlling for other differences in hospital and patient characteristics Heese then compared the amount of upcoding to the amount of charity care the hospitals were providing. The result Those in the top percent of charity care were percent less likely to be sanctioned for upcoding than those in the bottom percent. In addition he looked at which hospitals provided medical education for residents—another public benefit. Those hospitals in the top quartile in the number of residents per hospital bed were percent less Indonesia Mobile Number List likely to be sanctioned than those in the bottom quartile. I don t say that these organizations won t be sanctioned if they provide charity care but the likelihood is less says Heese. the uninsured and the more you provide medical education the less likely you will be subject to these enforcement actions.
While Heese doesn t examine the political motivation behind this he does note that politicians as well as regulators overseeing the health care industry have often acknowledged the insufficient compensation for hospitals that treat the uninsured and have allocated additional resources in recent years to help cover charity care—as well as offering higher reimbursement rates for hospitals providing medical education.
Controlling for other differences in hospital and patient characteristics Heese then compared the amount of upcoding to the amount of charity care the hospitals were providing. The result Those in the top percent of charity care were percent less likely to be sanctioned for upcoding than those in the bottom percent. In addition he looked at which hospitals provided medical education for residents—another public benefit. Those hospitals in the top quartile in the number of residents per hospital bed were percent less Indonesia Mobile Number List likely to be sanctioned than those in the bottom quartile. I don t say that these organizations won t be sanctioned if they provide charity care but the likelihood is less says Heese. the uninsured and the more you provide medical education the less likely you will be subject to these enforcement actions.
While Heese doesn t examine the political motivation behind this he does note that politicians as well as regulators overseeing the health care industry have often acknowledged the insufficient compensation for hospitals that treat the uninsured and have allocated additional resources in recent years to help cover charity care—as well as offering higher reimbursement rates for hospitals providing medical education.
