ArticleHealth affairs scholar2025
Coding intensity variation in Medicare Advantage.
Article in Health affairs scholar, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- Streamlining oversight in Medicare advantage: measuring coding intensity via contract rankings.Health affairs scholar · 2026Article
- Palliative Care for Advanced Cancer in Medicare Advantage and Physician Networks.JAMA network open · 2026Article
- Ten high-priority areas for health policy research in 2026-2027.Health affairs scholar · 2026Article
- Heterogeneous responses to risk-adjustment reform: evidence from dementia diagnosis in Medicare Advantage.Health affairs scholar · 2026Article
- Advancing the measurement of favorable selection in Medicare Advantage: evidence from encounter data.Health affairs scholar · 2026Article
- Exposure to the new Medicare Advantage risk adjustment model varies across insurers.Health affairs scholar · 2026Article
- Too Sick to be True? Evaluating Potentially Problematic Diagnosis Coding Practices in Medicare's Patient-Driven Payment Model.Health services research · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
Enrollment in Medicare Advantage (MA) plans rose to over 50% of eligible Medicare patients in 2023. Payments to MA plans incorporate risk scores that are largely based on patient diagnoses from the prior year, which incentivizes MA plans to code diagnoses more intensively. We estimated coding inflation rates for individual MA contracts using a method that allows for differential selection into contracts based on patient health. We illustrate the method using data on MA risk scores and health conditions from the most recent year available, 2014. This approach could also be used beginning in 2022, when Medicare transitioned to MA risk scores based on MA Encounter records. Several existing methods assess coding intensity, but this study's approach is novel in its use of plan-level mortality rates to infer plan-level coding intensity. We found an enrollment-weighted mean coding inflation rate of 8.4%, with rates ranging from 3.4% to 12.7% for the largest 8 MA insurers and from 1.1% to 22.2% for the largest 20 MA contracts in 2014. We found higher coding intensity for health plans that were HMOs, provider-owned, large, older, or had high star ratings. Approximately 68.1% of MA enrollees were in contracts with coding inflation rates larger than Medicare's coding intensity adjustment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.