Measuring Patient Case Mix in Medicare

How does Medicare measure patient case mix?  For the most part, Medicare uses the Hierarchical Condition Category (HCC) model.  A recent CMS presentation describes the HCC model in more detail.  Today I review where CMS applies the HCC model, provide an overview of the HCC methodology, briefly describe its performance, and give some background on…

The Bernie Madoff of Medicare?

Physicians earn high salaries.  The Bureau of Labor Statistics notes that the median primary care physicians made $186,044, and specialists typically earn  $339,738.   Some physicians earn much more than that, but not always through legitimate means. Consider the case of Dr. Jacques Roy: Federal law enforcement officials announced charges in the largest healthcare fraud scam…