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Igor would look for patterns, such as a concentration of payments close to the top limit and their destinations, and then compare those payments with all the others in the system.
Yet the concentration of payments — a mere 2% of the doctors participating in the program took in almost a quarter of the fees — exemplifies the problem with Medicare's "fee for service" payment system.
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When the Kakwani index is negative (πk < 0), the system is regressive, so that the concentration curve of payments (Lpay) lies above the Lorenz curve of income (Linc).
When the Kakwani index is positive (πk > 0), the health care financing system is progressive, so that the Lorenz curve of income (Linc) lies above the concentration curve of payments (Lpay).
The higher concentration of catastrophic payments among the poorest households is also confirmed by the negative values of concentration indices for the incidence of catastrophic payment (C_E).
§ 838.232 Suspension of payments.
(1 Aggregation of payments.
§ 838.233 Termination of payments.
(4 Adjustment of payments.
(e)Total of payments.
Empirical studies on informal patient payments attribute different characteristics to this type of payments.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com