Healthcare Finance News December 27, 2017
For 2019, CMS will blend 25 percent of encounter data into risk scores for MA payment.
The Centers for Medicare and Medicaid Services on Wednesday released the first part of its 2019 advance notice of changes for Medicare Advantage capitation rates and Part D payment policies.
This includes a change in the percent of encounter data used for payment, a policy that in the past has raised concerns.
[Also: Physician groups urge CMS for policies that would allow them to compete with hospitals]
Historically, CMS has used diagnoses submitted into CMS’ risk adjustment payment system by Medicare Advantage organizations.
In recent years, CMS began collecting encounter data from Medicare Advantage organizations, which also includes diagnostic information, in the method...
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