"Modifying the HCC model is not a simple technical update or revision," the AMGA says. CMS recently released proposed changes to the CMS-HCC Risk Adjustment Model for payment year 2024 in February, ...
The Centers for Medicare & Medicaid Services (CMS) recently released its 2026 Medicare Advantage (MA) Rate Announcement, projecting a 5.06% average increase in payments to MA plans — a significant ...
Two years ago, I would have told you that autonomous AI coding was too risky for risk adjustment. Today, I'm implementing it—but only after finding an approach that met my compliance requirements.
Introduces New Model That Delivers Greater Coding Precision and Automation to Reduce Errors, Accelerate Payments, and Close the Loop Between Care and Revenue REDWOOD CITY, CALIF. — October 20, 2025 – ...
The full 2026 rollout of CMS-HCC V28 is reshaping Medicare Advantage payments, trimming over 2,000 diagnosis codes and lowering average risk scores by more than three percent — a shift that demands ...
The Alliance of Community Health Plans is calling out risk adjustment scores by larger insurers in Medicare Advantage plans. ACHP, an organization that advocates for smaller health plans, said the ...
On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Rate ...
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