Tag Archives: hierarchical condition categories

2014 Holds Big Changes for the CMS-HCC Model

The purpose of the CMS-HCC model is to improve the accuracy in predicting the costliness of Medicare Advantage (MA) enrollees’ healthcare costs and to properly fund MA plans for those expenses. It isn’t a perfect model but it surpasses the … Read Full Post

Tagged annual wellness visits, center for medicare and medicaid services, chronic kidney disease, cms-hcc model, ffs medicare, government accountability office, health risk appraisals, hierarchical condition categories, medicare advantage enrolles risk scores, medicare advantage plans, medicare payment advisory commission, medicare risk adjustment, mra, national institutes of health, national kidney foundation, risk adjustment in medicare advantage, risk scores, the patient protection and affordable care act |

CMS Risk Adjustment Data Submission Deadlines and Payment Schedule

The nature of capitation and the risk adjustment payment method requires specific deadlines for data submission that correlate to dates of service and affect capitation payments. The Centers for Medicare and Medicaid Services (CMS) observes the following three deadlines each … Read Full Post

Tagged cms, cms risk adjustment, hierarchical condition categories, icd-9-cm, medicare advantage plans, medicare risk adjustment, mra, risk adjustment processing system |

Tag Archives: hierarchical condition categories

2014 Holds Big Changes for the CMS-HCC Model

CMS Risk Adjustment Data Submission Deadlines and Payment Schedule

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