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Challenges of Medicare Advantage and Healthcare Practices
This chapter explores UnitedHealthcare's upcoding practices in the transition from fee-for-service Medicare to Medicare Advantage, revealing discrepancies in patient sickness scores. It highlights the potential for billing abuses, the impact of regulatory actions on the Medicare Advantage sector, and the need for reforms in payment systems. Additionally, the chapter touches on the complexities of the pandemic's impact on healthcare and related industries, emphasizing systemic inefficiencies and health management challenges.