Last week the Centers for Medicare & Medicaid Services proposed to phase in a new risk adjustment model for Medicare Advantage plans for 2022. This move is required by the 21st Century Cures Act, and follows moves by the agency to phase in other risk models for MA payments.
From the September 14 press release from CMS:
CMS is...CMS Rules
CMS wants to increase the amount of encounter data the agency uses to calculate Medicare Advantage (MA) risk scores from 50% to 75%; final 2021 MA payment rates are expected on or before April 6.
Even as the industry continues to express concern over the reliability of encounter data, The HCC Risk Adjustment Model is now driven by...National News
A recent survey by The Office of the National Coordinator for Health Information (ONC) indicates that the desire for patient access to electronic medical records is declining. ONC has long argued that patient’s electronic access to their medical records is critical to empowering individuals to monitor and manage their own health care....
The 21st Century Cures Act requires changes to the risk adjustment model for aged and disabled beneficiaries enrolled in Medicare Advantage Part C plans beginning in calendar year 2019.
For 2019, the agency proposes adding mental health, substance use disorder and chronic kidney disease conditions to the risk adjustment model and...