Becker's Healthcare December 18, 2025
Facing a shifting regulatory landscape and provider tensions, some insurers have reached a crossroads with Medicare Advantage. This year proved pivotal in shaping how payers would move forward.
Here are the 3 biggest trends from the year:
1. Coding intensity has been a major concern in MA. The Medicare Payment Advisory Commission attributed $40 billion in additional federal spending to coding intensity alone. This year, insurers addressed increased emergency room use, greater morbidity, and steeper demand for behavioral health and specialty drugs — especially in MA. Provider coding practices may underlie some of these worries. Several health insurance leaders, including UnitedHealthcare CEO Tim Noel and Elevance CEO Gail Boudreaux, cited pressure...
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