Medicare Advantage Payment & Coding Fights Intensify

Medicare Advantage Payment & Coding Fights Intensify

From Health Affairs This Week by Health Affairs

March 20, 2026 · 15 min · Episode 238

About this episode

The episode discusses the debate over Medicare Advantage payments and coding intensity with insights from a new study.

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 )

People in this episode

Host: Jeff Byers

Guest: Ben Ippolito

Topics covered

  • Medicare Advantage
  • health policy
  • coding intensity
  • federal payments
  • diagnostic upcoding
  • healthcare reform

Keywords

  • Medicare Advantage
  • coding intensity
  • federal payments
  • diagnostic upcoding
  • health policy
  • healthcare reform

Mentioned in this episode

Organizations: American Enterprise Institute, Health Affairs, Harvard Medical School, Wall Street Journal, Healthcare Dive

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