Abstract
Ambient AI “digital scribes” are rapidly moving into routine practice, easing documentation burden and physician burnout. Early evidence suggests these tools can increase billing and risk-adjustment coding intensity, prompting payer responses such as downcoding and risk-score recalibration. This Policy Brief contrasts their implications in fee-for-service and Medicare Advantage models, notes relevance for systems blending encounter-based and capitated payment, and outlines steps to preserve value without fueling a coding arms race.