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 ...

Review Proposed Changes for Medicare Advantage Plans in 2024 Discuss the change from Version 24 to Version 28 and the impact on Risk Adjustment Calculation Methodology Explain how Fee-for-Service will ...

"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, ...

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Rate ...

A growing range of policy discussions correctly assert that the current Centers for Medicare and Medicaid Services’ (CMS) risk-adjustment system needs modernization, reflecting its long history and ...

A federal lawsuit has focused attention on how the industry uses medical codes for risk adjustment. While the lawsuit doesn’t involve physician practices, it’s a heads-up for them to pay attention to ...

A federal lawsuit claims that UnitedHealth Group, the largest Medicare Advantage insurer in the country, is coding medical claims inappropriately for monetary gain. But while the lawsuit doesn't ...

"Healthcare organizations face mounting challenges from risk adjustment coding complexity, impacting both patient care and revenue accuracy. Point of Care Suspects builds on our market-proven, best-in ...