Accurate risk adjustment isn’t just a box to check; it’s now a strategic lever. Hierarchical Condition Category (HCC) coding underpins risk scores that drive Medicare Advantage and other value-based ...
The Centers for Medicare & Medicaid Services (CMS) recently released its 2026 Medicare Advantage (MA) Rate Announcement, projecting a 5.06% average increase in payments to MA plans — a significant ...
Bigger payment boost: CMS finalized a 5.06% Medicare Advantage payment increase for 2026, up from 2.23% in the proposal, totaling over $25 billion. New risk model: The V28 risk adjustment model takes ...
CMS uses the HCC score to mitigate selection incentives due to difference in average costs between beneficiaries with different HCC scores. Paradoxically, the way CMS calibrates the HCC bolsters MA ...
The Alliance of Community Health Plans is calling out risk adjustment scores by larger insurers in Medicare Advantage plans. ACHP, an organization that advocates for smaller health plans, said the ...
United States, 7th Aug 2024 - In the realm of healthcare, precision is everything. The accuracy of Hierarchical Condition Category (HCC) risk scores plays a pivotal role in the financial health of ...
On January 31, 2024, the Centers for Medicare and Medicaid Services (CMS) released the Calendar Year (CY) 2025 Advance Notice for Methodological Changes for Medicare Advantage Capitation Rates and ...
The Centers for Medicare & Medicaid Services (CMS) released its Advance Notice of Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D ...
Wellbeing Magazine on MSN
Top 10 risk adjustment platforms for smarter value-based care
This is my hands-on evaluation of 10 risk adjustment platforms for value-based care teams preparing for 2026 Medicare ...
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