Detecting Medicare Abuse

35 Pages Posted: 6 Sep 2004 Last revised: 5 Sep 2010

See all articles by David J. Becker

David J. Becker

University of Alabama at Birmingham -- School of Public Health

Daniel P. Kessler

Stanford Graduate School of Business; National Bureau of Economic Research (NBER)

Mark B. McClellan

Brookings Institution; Council of Economic Advisors; National Bureau of Economic Research (NBER)

Date Written: August 2004

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.

Suggested Citation

Becker, David James and Kessler, Daniel Philip and McClellan, Mark B., Detecting Medicare Abuse (August 2004). NBER Working Paper No. w10677. Available at SSRN: https://ssrn.com/abstract=579820

David James Becker

University of Alabama at Birmingham -- School of Public Health ( email )

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Daniel Philip Kessler (Contact Author)

Stanford Graduate School of Business ( email )

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National Bureau of Economic Research (NBER)

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Mark B. McClellan

Brookings Institution ( email )

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Council of Economic Advisors ( email )

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National Bureau of Economic Research (NBER) ( email )

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Cambridge, MA 02138
United States

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