Bridging The Medicare Risk Gap: How AI Can Enhance Coding Accuracy And Equity

By Michael S. Barr, Tony Zhou for HealthAffairs on March 13, 2025

As Medicare payment models evolve, reconciling differences in coding intensity between Medicare Advantage (MA) and traditional Medicare (TM) is a persistent challenge. High coding intensity in MA and under coding in TM—often due to resource constraints and limited incentives—creates a risk gap that distorts payments and resource allocation and affects patient care. Here…

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