![]() Third, within HRRs, agencies sharing more patients with other agencies were predicted to increase spending the following year. Second, we establish that the HRR-level BMIX (but not other network measures) was a strong predictor of above-average home care expenditures across HRRs. First, we find a remarkable increase in home health care activity between 20 in some but not all regions average billing per Medicare enrollees in McAllen TX and Miami increased by $2,127 and $2,422 compared to a $289 increase in other HRRs not targeted by the Department of Justice. We hypothesize that patient-sharing across home health care agencies provides a mechanism for the rapid diffusion of fraudulent strategies we measure such activity using a novel bipartite mixture (or BMIX) network index. In this paper, we consider the diffusion of potentially fraudulent Medicare home health care billing in the United States during 2002-16, with a focus on the 21 hospital referral regions (HRRs) covered by local Department of Justice anti-fraud “strike force” offices. ![]() Many studies have examined the diffusion of health care innovations but less is known about the diffusion of health care fraud. ![]()
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