Risk Adjustment, Insurance Markets, And More.

The article discusses various aspects of health care markets, focusing on risk adjustment, insurance competition, provider payment rates, and access to care. It highlights findings on upcoding in Medicare Advantage (MA) plans, undercoding in traditional Medicare, and the paradox of increasing concen...

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Detalles Bibliográficos
Publicado en:Health Affairs Vol. 43; no. 12; pp. 1613 - 1614
Autor principal: WEIL, ALAN R.
Formato: editorial Journal Article
Publicado: Health Affairs Publishing, LLC Dec2024
Acceso en línea:Ver este registro en EBSCOhost
Descripción
Sumario:The article discusses various aspects of health care markets, focusing on risk adjustment, insurance competition, provider payment rates, and access to care. It highlights findings on upcoding in Medicare Advantage (MA) plans, undercoding in traditional Medicare, and the paradox of increasing concentration among MA plans despite local competition. Additionally, it examines the implications of payment rates in different insurance markets, the financial challenges faced by rural hospitals, and the decline of retail pharmacies in predominantly Black neighborhoods. The article emphasizes the need for improved regulation and support for rural health care access.