“The Medicare Advantage Money Grab” revealed nearly $70 billion in “improper” Medicare payments to the health plans from 2008 through 2013. The investigation exposed how federal officials missed multiple opportunities to corral tens of billions of dollars in overcharges and other billing errors tied to inflated risk scores. We also showed how the industry has turned to questionable home visits and sophisticated “data mining” analysis of patient medical records to raise risk scores even further with little government oversight. Our analysis of risk score growth used government data for the first time to plot changes in risk scores at more than 5,700 health plans in 3,000 counties nationwide between 2007 and 2011. We published two interactive graphic devices that allowed readers to view these changes by county and states for the first time.
