Hospice News October 16, 2023
Depending on how stakeholders play their cards, the U.S. Centers for Medicare & Medicaid Services’ (CMS) updated risk adjustment policy could lead to tightened belts — or a golden opportunity — for palliative care providers in Medicare Advantage.
Much of the palliative care delivered to U.S. patients is now reimbursed through risk-based models like Medicare Advantage and Accountable Care Organizations (ACOs). And those payments are determined in part by risk adjustment, a system that CMS plans to change next year in an effort to rein in spending.
Though reactions will likely differ from plan to plan, this could potentially mean that providers could see lower payments, according Dr. Sachin Jain, CEO of the Medicare Advantage organization The SCAN Group.
“The...
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