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Full-Text Articles in Business Administration, Management, and Operations
Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul Iii, Sarah Clemente, Ronald Mcgrady, Rob Repass, Alberto Coustasse
Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul Iii, Sarah Clemente, Ronald Mcgrady, Rob Repass, Alberto Coustasse
Alberto Coustasse, DrPH, MD, MBA, MPH
Medicare fraud and abuse costs are estimated at 3%-10% of overall Medicare spending, which is expected to expand considerably until 2024 and as such the amount of fraud dollars would be expected to increase proportionally. The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. The breadth of fraud and abuse within Medicare as well as recent reforms to fight fraud including legislative reforms, delivery system reforms, and other reforms including the formation of HEAT …
Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul Iii, Sarah Clemente, Ronald Mcgrady, Rob Repass, Alberto Coustasse
Medicare And The Aca: Shifting The Paradigm Of Fraud Detection, David P. Paul Iii, Sarah Clemente, Ronald Mcgrady, Rob Repass, Alberto Coustasse
Management Faculty Research
Medicare fraud and abuse costs are estimated at 3%-10% of overall Medicare spending, which is expected to expand considerably until 2024 and as such the amount of fraud dollars would be expected to increase proportionally. The purpose of this research was to determine how recent reforms, especially the Patient Protection and Accountable Care Act, may affect Medicare fraud and abuse and to uncover the best strategies to combat Medicare fraud. The breadth of fraud and abuse within Medicare as well as recent reforms to fight fraud including legislative reforms, delivery system reforms, and other reforms including the formation of HEAT …
Evolution Of Physician-Centric Business Models Under The Patient Protection And Affordable Care Act, Tanya Nix, Lynn Szostek
Evolution Of Physician-Centric Business Models Under The Patient Protection And Affordable Care Act, Tanya Nix, Lynn Szostek
International Journal of Applied Management and Technology
For decades, the cost of medical care in the United States has increased exponentially. United States citizens spend twice as much as their European counterparts on medical care. Congress enacted the Patient Protection and Affordable Care Act (PPACA) to ensure affordable healthcare to the citizens of the United States. PPACA legislation is creating a new paradigm in healthcare delivery and provider business models. The purpose of this case study was to explore physicians’ perspectives regarding physician-centric business models evolving under the requirements of the PPACA legislation. Data were gathered through semistructured interviews and questionnaires with a purposive sample of 75 …