Republicans in Congress have made a lot of noise about eliminating “waste and fraud” in federal health-care spending. If they ...

Differential coding by Medicare Advantage plans appeared to have pushed their risk scores higher than traditional Medicare's scores. Those greater risk scores led to $33 billion in extra revenue ...

Get Instant Summarized Text (Gist) Medicare Advantage (MA) plans received an estimated $33 billion in additional revenue in 2021 due to coding differences compared to Traditional Medicare (TM ...

In 2021, UnitedHealth Group received 42% of the $33 billion in additional Medicare Advantage payments from differential coding. Due to differential coding in Medicare Advantage (MA), risk scores ...

PRO, but as the rules are new for January 2025, the exact coverage details, including out-of-pocket costs, are unclear. Read more.

Intensive coding by Medicare Advantage (MA) plans raised enrollees' risk scores and may have allowed companies to pocket tens of billions of dollars more than if traditional Medicare had covered the ...

The average risk score for UnitedHealthcare Medicare Advantage policyholders was 1.35. “Differential coding resulted in an estimated increase in revenue of $1,863 per member at UnitedHealth ...

The Biden administration tried to eliminate Medicare Advantage plans by establishing inadequate benchmarks. In January, less ...

As policy makers consider programmatic changes that would restrict MA plans’ ability to manage care, they should be mindful ...

Nationwide, 58% of Medicare beneficiaries living in rural areas are enrolled in stand-alone prescription drug plans in 2025.

Medicare Advantage plans received an extra $33 billion in revenue from the feds in 2021 due to coding differences in billing compared to traditional Medicare, researchers reported Monday in the Annals ...