Researchers Find More Accurate Model for Estimating Patient Costs

Using single diagnostic codes and leveraging “present on admission” designations improved Medicare payment models, predicting total patients costs within 30 days of hospitalization better than the current grouped diagnostic code method, a study published in JAMA Open Network found.

Changing the variables currently used by CMS in patient cost prediction models could have serious implications for research, benchmarking public reporting, and calculations of population-based payments in programs like Medicare Advantage, researchers said.

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