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. Author manuscript; available in PMC: 2022 Sep 12.
Published in final edited form as: Health Aff (Millwood). 2022 Jan;41(1):120–128. doi: 10.1377/hlthaff.2021.01054

Exhibit 1 (Figure). Shares of Medicare Advantage spending denied under Traditional Medicare coverage rules and private insurer (Aetna Medicare Advantage) coverage rules, by year.

Exhibit 1 (Figure).

Source: Authors’ calculations, 2014–2019 Aetna Medicare Advantage claims.

Notes: Shares are presented as the percent of spending denied either due to Medicare coverage determinations or due to Aetna Medicare Advantage coverage rules. Share denominators include paid services and denials due to coverage criteria. Denials due to other (i.e. administrative) reasons and prescription claims are not included in share numerator or denominator values. Error bars represent 95% confidence intervals for total denials from both sets of coverage rules.