Some limits on how the assessments are used for adding new diagnosis codes might be justified to ensure Medicare Advantage plans aren’t overpaid, researchers wrote. Under MA, insurers contract with ...

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An analysis of differential coding patterns between Medicare Advantage (MA) and Traditional Medicare (TM) plans estimated how much coding differs between insurers and how much extra revenue insurers ...

In today’s tech-driven healthcare landscape, artificial intelligence (AI) is transforming how healthcare organizations process data, manage workflows and optimize outcomes. Among the most promising ...

BOT or NOT? This special series explores the evolving relationship between humans and machines, examining the ways that robots, artificial intelligence and automation are impacting our work and lives.

Differential coding in MA plans results in higher risk scores and increased payments compared to TM, with significant insurer variation. UnitedHealth Group's risk scores were significantly higher than ...