Medicare Advantage plans, offshoots of traditional Medicare that work on an HMO model, were intended to provide more coordinated care for seniors at a lower cost; 31 percent of Medicare beneficiaries were enrolled in 2015. But 2012 payments for patients in Medicare Advantage plans were in fact 8 percent higher per patient than in fee-for-service plans, where patients could visit any physician or hospital. That excess is likely at least in part the result of coordinated efforts to raise risk scores, extracting billions in dubious billing.
