Becker's Healthcare May 8, 2024
Limiting the use of health risk assessments in Medicare Advantage could save the federal government billions each year, a study published May 6 in Health Affairs found.
CMS encourages Medicare Advantage plans to conduct annual surveys of patients’ health status, known as health risk assessments. These reviews can be used to connect members with additional resources but often add diagnosis to a patient’s risk score, according to the study. These reviews inflate payments MA plans receive per member, based on their health risks.
Because of this inflation, the Medicare Payment and Advisory Commission has recommended excluding diagnoses captured in health risk assessments from risk adjustment calculations, according to the study.
Researchers examined data for beneficiaries enrolled in...
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