Medicare Advantage Payment & Coding Fights Intensify

This episode is brought to you by Semafor Healthcare.Delivered weekly from David Lim, Semafor Healthcare connects the dots between decisions in government, business, and technology to reveal how they impact the future of healthcare. Each edition will provide the analysis you need to understand and stay ahead of a rapidly changing landscape. Subscribe for free.Health Affairs' Jeff Byers welcomes Ben Ippolito of the American Enterprise Institute to the pod to discuss the growing debate over Medicare Advantage (MA) payments and coding intensity. They break down why MA plans typically receive higher federal payments than traditional Medicare, how diagnostic upcoding factors into that gap, and what a new study in Health Affairs Scholar reveals about policy changes aimed at reducing inflated coding. On March 24th, join us for our upcoming Insider exclusive event focusing on pharmacy benefit manager reform with Harvard Medical School's Benjamin Rome.Related Articles:An updated analysis of coding pattern differences in Medicare Advantage (Health Affairs Scholar)The Trouble With MedPAC (Wall Street Journal)The Higher Price Tag on Medicare Advantage (Wall Street Journal)Aligning The MedPAC And CMS Estimates Of Coding Intensity: The Importance Of The Risk Model And Trend (Health Affairs Forefront)Medicare Advantage growth decelerates as insurers shed members for 2026 (Healthcare Dive) Subscribe to Semafor Healthcare for free.