Detecting Medicare abuse

被引：35

作者：

Becker, D

Kessler, D ^{[1
]}

McClellan, M

机构：

[1] Stanford Univ, Grad Sch Business, Hoover Inst, Stanford, CA 94305 USA

[2] NBER, Stanford, CA 94305 USA

[3] Univ Calif Berkeley, Berkeley, CA 94720 USA

[4] NBER, Baltimore, MD 21244 USA

[5] Ctr Medicare & Medicaid Serv, Baltimore, MD 21244 USA

来源：

JOURNAL OF HEALTH ECONOMICS | 2005年 / 24卷 / 01期

关键词：

Medicare abuse; anti-fraud enforcement; Medicare beneficiaries;

D O I：

10.1016/j.jhealeco.2004.07.002

中图分类号：

F [经济];

学科分类号：

02 ;

摘要：

This paper identifies which types of patients and hospitals have abusive Medicare billings that are responsive to law enforcement. For a 20% random sample of elderly Medicare beneficiaries hospitalized from 1994 to 1998 with one or more of six illnesses that are prone to abuse, we obtain longitudinal claims data linked with social security death records, hospital characteristics, and state/year-level anti-fraud enforcement efforts. We show that increased enforcement leads certain types of types of patients and hospitals to have lower billings, without adverse consequences for patients' health outcomes. (C) 2004 Elsevier B.V. All rights reserved.

引用

页码：189 / 210

页数：22

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