Fierce Healthcare January 2, 2018
Leslie Small

CMS is proposing changes to how it calculates Medicare Advantage risk scores.

Over the holidays, Medicare Advantage insurers got a gift from the federal government.

That gift arrived on Dec. 27, when the Centers for Medicare & Medicaid Services released part one (PDF) of its 2019 advance notice of changes to MA capitation rates and Part D payment policies. The advance notice is split into two parts this year because of requirements related to the 21stCentury Cures Act, per a CMS fact sheet.

To comply with the Cures Act, CMS is proposing an MA risk adjustment model that includes additional mental health, substance use disorder and chronic kidney disease conditions. The agency uses risk adjustment models to adjust payments based...

Today's Sponsors

LEK
ZeOmega

Today's Sponsor

LEK

 
Topics: CMS, Health System / Hospital, Medicare Advantage, Payer, Primary care
Navigating Medicare Advantage in 2025: Strategies for Success Amid Uncertainty
Improving Medicare Advantage By Accounting For Large Differences In Upcoding Across Plans
Medicare Advantage Enrollees Use Less Home Health Care In Their Final Days Than Traditional Medicare Patients
Medicare Advantage insurers ranked by prior authorization denial rates | 2023
Why Yale New Haven is having 'frank conversations' about MA

Share This Article