Jessica Mendoza

My colleagues Ana and Chris have been investigating the Medicare Advantage program for over a year. So when you and the team looked into the program, what did you find?

My colleagues Ana and Chris have been investigating the Medicare Advantage program for over a year. So when you and the team looked into the program, what did you find?

Over the next two episodes, we'll lay out some of what the journal's investigative reporting team found. Today is about how insurers use questionable practices to profit off of the Medicare system.

Over the next two episodes, we'll lay out some of what the journal's investigative reporting team found. Today is about how insurers use questionable practices to profit off of the Medicare system.

Over the next two episodes, we'll lay out some of what the journal's investigative reporting team found. Today is about how insurers use questionable practices to profit off of the Medicare system.

Welcome to The Journal, our show about money, business, and power. I'm Jessica Mendoza. It's Friday, June 6th. This is Medicare, Inc. Part 1. How private insurers pocketed billions from Medicare. So, Ana, Chris, why did you guys want to look into Medicare Advantage in the first place?

Welcome to The Journal, our show about money, business, and power. I'm Jessica Mendoza. It's Friday, June 6th. This is Medicare, Inc. Part 1. How private insurers pocketed billions from Medicare. So, Ana, Chris, why did you guys want to look into Medicare Advantage in the first place?

Welcome to The Journal, our show about money, business, and power. I'm Jessica Mendoza. It's Friday, June 6th. This is Medicare, Inc. Part 1. How private insurers pocketed billions from Medicare. So, Ana, Chris, why did you guys want to look into Medicare Advantage in the first place?

In 2023, the investigations team got their hands on Medicare data that goes back about a decade. The information included things like service charges and other records.

In 2023, the investigations team got their hands on Medicare data that goes back about a decade. The information included things like service charges and other records.

In 2023, the investigations team got their hands on Medicare data that goes back about a decade. The information included things like service charges and other records.

As they went through the data, something stood out to Chris. There were diagnoses on patients' records that were put there by insurers. This is important because of how Medicare Advantage works. For certain kinds of diagnoses, many of which are expensive to treat, the private insurer gets an extra payment from the government. That payment is meant to cover the cost of treatment.

As they went through the data, something stood out to Chris. There were diagnoses on patients' records that were put there by insurers. This is important because of how Medicare Advantage works. For certain kinds of diagnoses, many of which are expensive to treat, the private insurer gets an extra payment from the government. That payment is meant to cover the cost of treatment.

As they went through the data, something stood out to Chris. There were diagnoses on patients' records that were put there by insurers. This is important because of how Medicare Advantage works. For certain kinds of diagnoses, many of which are expensive to treat, the private insurer gets an extra payment from the government. That payment is meant to cover the cost of treatment.

And what do the health insurance companies have to say about your reporting?

And what do the health insurance companies have to say about your reporting?

And what do the health insurance companies have to say about your reporting?

Last year, the team published a series of stories based on the data and their reporting. One of those stories caught the eye of a nurse practitioner, and what she read really resonated with her.

Last year, the team published a series of stories based on the data and their reporting. One of those stories caught the eye of a nurse practitioner, and what she read really resonated with her.

Last year, the team published a series of stories based on the data and their reporting. One of those stories caught the eye of a nurse practitioner, and what she read really resonated with her.