MedPage Today January 20, 2026
Difference in spending attributed to ‘coding intensity’ and ‘favorable selection’
The Centers for Medicare & Medicaid Services (CMS) is continuing to pay Medicare Advantage (MA) plans more — $76 billion more in 2026 — than if those same patients were enrolled in traditional fee-for-service Medicare.
That higher cost comes despite a policy CMS redesigned in 2024 to limit MA plans’ ability to exaggerate patients’ health risks to garner higher monthly payments.
This finding was among those from a status report on Medicare plans presented last week to the Medicare Payment Advisory Commission (MedPAC), which advises CMS on Medicare policies.
The report attributed the difference in spending between MA and traditional Medicare to two factors: MA plans’ “coding intensity,” the practice...
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