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Center for Advancing Health Policy through Research

Medicare

Medicare now covers over 65 million Americans and remains a cornerstone of the U.S. health care system. Yet the program faces mounting challenges—rising costs, plan complexity, and variation in access and quality.

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Our Medicare Portfolio

Dive into our work on Medicare — from academic research to policy briefs and real-world commentary.

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Medicare

Medicare now covers over 65 million Americans and remains a cornerstone of the U.S. health care system. Yet the program faces mounting challenges—rising costs, plan complexity, and variation in access and quality.

About the Medicare Lab

CAHPR’s Medicare Lab brings together researchers evaluating reforms to address Medicare’s sustainability, transparency, and value for beneficiaries and taxpayers alike. Our work spans Medicare Advantage, Traditional Medicare, and supplemental coverage programs. Using administrative and claims data, the lab investigates issues such as coding intensity, price growth, plan performance, and benefit design. By combining rigorous evidence with policy simulation tools, we help inform legislative and regulatory reforms aimed at improving accountability, competition, and equity within Medicare.

The Big Questions

  • Where can we design smarter incentives to reduce waste and unnecessary spending in Medicare?
  • How do current payment rules and risk adjustment methods create incentives for upcoding or overbilling?
  • How can oversight and accountability be strengthened to prevent inaccurate coding, inflated payments, or improper plan behavior?

Featured Work

Recent Publications

  • U.S. Physician Medicare Program Participation and Exit, 2013-2023
  • Medicare Advantage Plan Spending and Payments Under the Hospice Carve-Out
  • Algorithmic decision-making in health care: Evidence from post-acute care in Medicare Advantage
  • Accountable Care Organization Assignment and Outcomes and Spending for TEAM Surgical Conditions
  • Sharp Rise In Urban Hospitals With Rural Status In Medicare, 2017–23
  • Surgical Outcomes and Medicare Advantage Payer-Hospital Integration

Events & Policy Discussions

  • Surgical Outcomes and Medicare Advantage Payer-Hospital Integration?
  • Medicare Advantage Payment and Opportunities for Cost Containment
  • The Future of Medicare: The Rise of Medicare Advantage and What Comes Next

MediCode Tool

The MediCode tool provides insights into how Medicare Advantage plans may be inflating risk scores and receiving billions in additional federal payments.

Explore the Tool

From Statehouses to Capitol Hill

Turning Evidence into Policy

  • Our Work in Federal Policy
  • Our Work in State Policy

Experts

  • David Meyers

    David J. Meyers Ph.D., MPH

    Medicare Lab Lead, Associate Director for the Center for Advancing Health Policy Through Research, Associate Professor of Health Services, Policy & Practice
    david_meyers@brown.edu
  • Kosar

    Cyrus M. Kosar Ph.D.

    Assistant Professor of Health Services, Policy & Practice
    cyrus_kosar@brown.edu
  • Jeff Marr

    Jeffrey Marr Ph.D.

    Assistant Professor of Health Services, Policy & Practice
    jeffrey_marr@brown.edu
  • Andrew Ryan

    Andrew M. Ryan Ph.D.

    Director for the Center for Advancing Health Policy Through Research, Professor of Health Services, Policy & Practice
    andrew_m_ryan@brown.edu

Recent medicare articles

Show all medicare news
McKnights

Insurer use of algorithms cuts SNF length of stay by 13%

December 3, 2025
by Kimberly Marselas
Read Article
STAT News

How much damage did the federal shutdown do to telehealth?

November 11, 2025
By Mario Aguilar
Read Article
The Providence Journal

It's open enrollment time in RI. How to choose between Medicare, Medicare Advantage

November 6, 2025
While Medicare Advantage offers many advantages, it also has drawbacks that should be considered
Read Article
STAT News

Hospitals get dinged for reporting too many infections. In some cases, the solution is not to test

September 22, 2025
Hospitals are discouraging infection testing to avoid Medicare penalties, a practice clinicians say jeopardizes patient safety and skews public reporting. As Brown University’s Andrew Ryan put it, “Basically, the measures are just really, really bad … this is honestly the worst” pay-for-performance program, underscoring deep flaws in how infection penalties are designed and enforced.
Read Article
The Minnesota Star Tribune

Why UnitedHealth’s Medicare Advantage program is under attack

September 20, 2025
UnitedHealth’s Medicare Advantage program has come under scrutiny for allegedly exploiting diagnostic “upcoding” practices that drive billions in excess federal payments. Brown University researchers have launched Medicoding.org, a public tool that tracks how diagnostic coding in Medicare Advantage inflates payments to insurers. Health economist David Meyers explains that while some coding reflects real patient needs, much of the increase stems from insurers “gaming the system,” making beneficiaries appear sicker than they are
Read Article
Yahoo Finance

Trump administration tiptoes into testing prior authorization in traditional Medicare

August 17, 2025
Traditional Medicare plan holders have typically not had to wait for prior authorization before receiving medical treatment. CMS recently announced a new program to test prior authorization requirements for certain services in six states to root out fraud, waste and abuse. Jeffrey Marr highlights what’s needed to set up a well-functioning prior authorization system.
Read Article

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Patient Rights Advocate

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Our Medicare Portfolio

Dive into our work on Medicare — from academic research to policy briefs and real-world commentary.

View all
CAHPR logo

Have a question or want to get in touch with us?

Email us
Brown University School of Public Health
Providence RI 02903 401-863-3375 public_health@brown.edu

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