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Using Medicare Advantage encounter data, this analysis finds that 62% of Medicare Advantage enrollees have at least one chart review record and that diagnoses added from chart reviews increase payments from CMS to insurers for 17% of enrollees. The use of chart reviews varies across the largest Medicare Advantage insurers.
This glossary serves as a guide to the sometimes arcane terms that inhabit the world of Medicare Advantage, the private plan alternative to traditional Medicare.
This brief explains how Medicare Advantage payments are determined and provides an overview of policy options to change the Medicare Advantage payment system.
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