"Modifying the HCC model is not a simple technical update or revision," the AMGA says. CMS recently released proposed changes to the CMS-HCC Risk Adjustment Model for payment year 2024 in February, ...
Health plan and industry trade groups are calling on the CMS to delay or not move forward entirely with proposed changes to the 2024 Medicare Advantage and Medicare Part D plans. The calls come as the ...
The Centers for Medicare & Medicaid Services (CMS) delayed the publication of the final rule on the use of extrapolation and the application of a fee-for-service adjuster (FFS Adjuster) in risk ...
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 ...
On April 1 st, the Centers for Medicare & Medicaid Services (“CMS”) announced its Medicare Advantage (“MA”) Capitation Rates and Part C and Part D Payment Policies for Calendar Year (“CY”) 2025. This ...
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