Detecting Medicare Abuse

David Becker, Daniel Kessler and Mark McClellan

No 10677, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: This paper identifies which types of patients and hospitals have abusive Medicare billings that are responsive to law enforcement. For a 20 percent random sample of elderly Medicare beneficiaries hospitalized from 1994-98 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.

JEL-codes: I1 K0 (search for similar items in EconPapers)
Date: 2004-08
New Economics Papers: this item is included in nep-hea and nep-law
Note: EH
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Published as Becker, David, Daniel Kessler and Mark McClellan. "Detecting Medicare Abuse," Journal of Health Economics, 2005, v24(1,Jan), 189-210.

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