Healthcare Finance News January 7, 2020
Risk scores will be calculated using 75% encounter data, an increase of 25% over this year.
The Centers for Medicare and Medicaid Services is continuing to phase in a greater percentage of encounter data in determining payments to Medicare Advantage plans.
CMS released Part I of the 2021 Advance Notice this week. Requirements in the 21st Century Cures Act mandate certain changes to risk adjustment and a 60-day comment period.
CMS is expected to finalize all changes to MA payments for 2020 in an annual rate announcement that will be released by April 1.
WHY THIS MATTERS
CMS uses the HCC (Hierarchical Condition Category) Risk Adjustment Model to determine risk scores. They are based, in part, on a patient’s health,...
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