<mods:mods xmlns:mods="http://www.loc.gov/mods/v3" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.loc.gov/mods/v3 http://www.loc.gov/standards/mods/v3/mods-3-8.xsd"><mods:titleInfo><mods:title>Corporate Practice of Medicine: Vertical Alignment and Medicare Advantage Risk Coding</mods:title></mods:titleInfo><mods:typeOfResource authority="primo">articles</mods:typeOfResource><mods:abstract>A long-appreciated, but understudied, aspect of vertical integration is the ability to align&#13;
incentives and enable coordination between principals and agents. We examine this&#13;
dynamic in the context of vertical alignment between physicians and corporate primary&#13;
care practices (CPCPs), which are often integrated with Medicare Advantage (MA) insurers.&#13;
While concerns of increased coding intensity in MA are well-documented, the mechanisms&#13;
that enable aggressive coding are less clear. Using hand-collected data on physician&#13;
employment by CPCPs and national MA encounter data, we find that switching employment&#13;
to a CPCP leads to an approximately 25% increase in MA risk score payments after 2 years&#13;
and a 35% increase by 5 years. We find no evidence of increased health care utilization or&#13;
an alternative risk score that uses pharmaceutical claims rather than recorded medical&#13;
diagnoses. The increase in risk scores is driven by low-acuity and discretionary diagnoses.&#13;
We estimate that higher risk-score payments due to integration lead to a $1.6 billion&#13;
increase in annual payments from taxpayers to MA insurers.</mods:abstract><mods:name><mods:namePart>David J. Meyers</mods:namePart><mods:role><mods:roleTerm authority="marcrelator" authorityURI="http://id.loc.gov/vocabulary/relators" valueURI="http://id.loc.gov/vocabulary/relators/aut">Author</mods:roleTerm></mods:role></mods:name><mods:name><mods:namePart>Jay Shroff</mods:namePart><mods:role><mods:roleTerm authority="marcrelator" authorityURI="http://id.loc.gov/vocabulary/relators" valueURI="http://id.loc.gov/vocabulary/relators/aut">Author</mods:roleTerm></mods:role></mods:name><mods:name><mods:namePart>Yashaswini Singh</mods:namePart><mods:role><mods:roleTerm authority="marcrelator" authorityURI="http://id.loc.gov/vocabulary/relators" valueURI="http://id.loc.gov/vocabulary/relators/aut">Author</mods:roleTerm></mods:role></mods:name><mods:name><mods:namePart>Christopher Whaley</mods:namePart><mods:role><mods:roleTerm authority="marcrelator" authorityURI="http://id.loc.gov/vocabulary/relators" valueURI="http://id.loc.gov/vocabulary/relators/aut">Author</mods:roleTerm></mods:role></mods:name><mods:originInfo><mods:dateCreated>2025</mods:dateCreated></mods:originInfo><mods:subject authority="local"><mods:topic>Medicare Advantage</mods:topic></mods:subject><mods:subject authority="local"><mods:topic>risk score payments</mods:topic></mods:subject><mods:subject authority="local"><mods:topic>principal-agent relationships</mods:topic></mods:subject><mods:subject authority="local"><mods:topic>health care provider consolidation</mods:topic></mods:subject><mods:genre>Working Paper</mods:genre><mods:accessCondition type="use and reproduction">All rights reserved</mods:accessCondition><mods:accessCondition type="rights statement" xlink:href="http://rightsstatements.org/vocab/InC/1.0/">In Copyright</mods:accessCondition><mods:accessCondition type="restriction on access">All Rights Reserved</mods:accessCondition><mods:identifier type="doi">10.26300/amm6-vh76</mods:identifier></mods:mods>