Forefront: It's Time To Create A National Long COVID Compensation Program
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Friday, September 16, 2022 | The Latest Research, Commentary, And News From Health Affairs
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Medicare Risk Adjustment
Medicare’s reintroduction of risk adjustment for Alzheimer’s disease and related dementias (ADRD) Hierarchical Condition Categories (HCCs) in 2020 created incentives for providers to increase the use of these codes.

In their new Health Affairs article, Natalia Festa and coauthors assess the accuracy of ADRD coding before the reintroduction of risk adjustment and compare claims with diagnosis codes included in the ADRD HCCs to a reference standard.

Comparing claims data with a clinical standard for ADRD, the authors demonstrate that such an increase has occurred.

“Incorporating ADRD HCCs into risk adjustment creates incentives for providers to increase the use of ADRD International Classification of Diseases codes in claims, resulting in a concomitant increase in the false-positive rate and decrease in the false-negative rate of cases ascertained using the HCC definition,” they report.

Festa and coauthors conclude, “Our findings suggest that there is potential for a considerable decrease in the rate of false-negative ADRD cases.”
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Elsewhere At Health Affairs
Today in Health Affairs Forefront, Howard Bauchner writes about the need for a National Long COVID Compensation Program (NLCCP).

If you like the work we publish on Forefront and our podcasts, you can show your support by becoming a Health Affairs Insider, and as an added bonus, you'll get a free gift for joining.
Health Affairs This Week
Walmart And Other Retailers Continue To Make Moves In Health Care

 Listen to Health Affairs' Jessica Bylander and Vabren Watts discuss a new partnership between Walmart and UnitedHealth Group, which will include efforts across retail health clinics, Medicare Advantage plans, and social determinants of health, as well as other health care moves from big retailers like Amazon and CVS.
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About Health Affairs

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