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Full-Text Articles in Business
Potential Savings From Consumer-Driven Health Plans, Jessica Mcnair, Brittany White, Christopher Miller, William Ferguson, Alberto Coustasse
Potential Savings From Consumer-Driven Health Plans, Jessica Mcnair, Brittany White, Christopher Miller, William Ferguson, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Consumer Driven Health Plans (CDHPs) have been identified as a high-deductible insurance option that has increased consumer responsibility while health care expenditures have decreased. Anticipated savings through the use of CDHPs have drawn increased interest of employers and policymakers. The increased need to control healthcare costs as well as healthcare utilization have also fostered the development of increased use of CDHPs. As the use of CDHPs have expanded, educated consumers have become more engaged in their healthcare services and have increased demands for transparency of healthcare costs. Healthcare costs, utilization, and moral hazard of this study are further discussed.
Personal Health Record Interoperability, Manal Alghamdi, Courtney Stanley, William K. Willis, Alberto Coustasse
Personal Health Record Interoperability, Manal Alghamdi, Courtney Stanley, William K. Willis, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Personal Health Records (PHRs) is a software application that allows patients to review their medical information remotely through a secure domain. There are four forms of PHRs which are; 1) self-contained Electronic Health Record (EHR), 2) self-contained EHR, 3) PHRs integrated care EHR controlled by health provider and partially by the patient/consumer, 4) PHRs integrated care EHR controlled by the patient/consumer. The methodology for this study was a literature review and semi-structure interview with a specialist in health information technology. Electronic databases used included PubMed, Academic Search Premier, EBSCOhost, LexisNexis and Google Scholar. A total of 38 sources were referenced. …
Implications Of Upcoding On Medicare, Katrina Cremeans, Samantha Marcum, Carli Followay, Jessica Oldaker, Alberto Coustasse
Implications Of Upcoding On Medicare, Katrina Cremeans, Samantha Marcum, Carli Followay, Jessica Oldaker, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
The complexity of and amount of funds involved in Medicare has led to a significant increase in the incidence of Medicare fraud. A type of Medicare fraud, upcoding, has contributed to excessive and unnecessary health care spending. Upcoding has been an illegal strategy that some providers have used to increase their Medicare reimbursement for certain conditions. This is accomplished by coding a provided service as a more expensive service than what was actually performed. With the proliferation of upcoding, there has been an astonishing $12.5 billion in fraudulent Medicare charges since 2007. The fraudulent strategy of upcoding to increase Medicare …
The Opioid Epidemic In West Virginia, Nicholas Bowden, Rachel Merino, Sruthi Katamneni, Alberto Coustasse
The Opioid Epidemic In West Virginia, Nicholas Bowden, Rachel Merino, Sruthi Katamneni, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
The rate of overdose-related to the use of licit and illicit opioids has drastically increased over the last decade in the U.S. The epicenter being West Virginia the highest rates of overdoses accounting for 41.5 deaths for 100,000 people among the 33,091 deaths in 2015. The number of people injecting drugs has increased from 36% in 2005 to 54% in 2015. The total U.S cost of prescription opioid abuse in 2011 has been estimated at $25 billion, and criminal-justice-system costs to $5.1 billion. The reasons for this opioid epidemic incidence in WV have been a combination of sociocultural factors, a …
Implications Of Upcoding On Medicare Fraud, Alberto Coustasse, Katrina Cremeans, Carli Followay, Jessica Oldaker
Implications Of Upcoding On Medicare Fraud, Alberto Coustasse, Katrina Cremeans, Carli Followay, Jessica Oldaker
Alberto Coustasse, DrPH, MD, MBA, MPH
The complexity of and quantity of funds involved in Medicare reimbursements have led to a significant increase in the number of Medicare fraud. A particular kind of Medicare fraud, upcoding, has contributed to excessive and avoidable health care spending. Upcoding has been an illegal tactic that some providers have used to increase their Medicare reimbursement for specific medical conditions. This is accomplished by coding a provided service as a more expensive service than what was performed. With the proliferation of upcoding, there has been an unprecedented $12.5 billion in fraudulent Medicare charges. While solving the problem of upcoding will not …