Healthcare DIVE May 8, 2024
Some limits on how the assessments are used for adding new diagnosis codes might be justified to ensure Medicare Advantage plans aren’t overpaid, researchers wrote.
Dive Brief:
- Restricting the risk-score impact of health risk assessments, or surveys of beneficiaries’ health status, in Medicare Advantage could reduce spending up to $12.3 billion per year, according to a study published this week in Health Affairs.
- Experts and policymakers have raised red flags about aggressive coding practices in MA that make beneficiaries look sicker in an attempt to receive higher payments from the federal government. The assessments could be used to boost code intensity, and some limits on their use may be justified, according to the study.
- Among enrollees with at...
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