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The authors state these results suggest that there may be certain services where MA plans pay more than FFS possibly because the FFS rates for those services are too low, but that there may be other services where MA plans pay less than FFS possibly because the FFS rates for those DRGs are too high (Maeda, Nelson, 2018 p

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A few commenters suggested that using EDI 835 ERA transaction data to calculate ( and encode the allowed amounts may be particularly difficult for small and rural hospitals with limited technical capacity