Tag Archives: cms-hcc model

A Moment of Silence for the Sunsetting MRA Program – Part 3

This has been a difficult series of articles for our company, summarizing the 2024 changes to the CMS-HCC risk adjustment model. And we imagine our clients are speechless when considering the financial ramifications to their businesses. If you’ve missed any … Read Full Post

Tagged cms-hcc model, mra, risk adjustment |

A Moment of Silence for the Sunsetting MRA Program – Part 2

By now, you may have come to terms that MRA, as we know it, is on its way out. If you’re not informed about the changes for 2024, we urge you to read the first installment of this article series. … Read Full Post

Tagged cms-hcc model, mra, risk adjustment |

A Moment of Silence for the Sunsetting MRA Program – Part 1

Since the CMS-HCC risk adjustment payment paradigm took effect in 2003, our company has seen considerable changes, but this year takes the cake, as they say. Frankly, a moment (or really, a week) of silence would be appropriate to mourn … Read Full Post

Tagged cms-hcc model, mra, risk adjustment |

The Balanced MRA Approach

Like grandparents who pepper conversations with comments like, “Back in the day…” we’ve been around the risk adjusted payment methodology since its birth in 2003. Back in the day LOL the provider community was largely in the dark about many … Read Full Post

Tagged cms-hcc model, mra, validation |

A Fundamental Disconnect of Risk Adjustment Documentation

When CMS launched the risk adjustment model for Medicare Advantage payments beginning in 2003, the reason for the change – in many minds – was shortened to, essentially, being paid more for sicker members. While this is one part of … Read Full Post

Tagged assessment, cms-hcc model, mra, risk adjusted |

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 |

Maximizing the first patient visit of a period

Risk adjusted reimbursement hinges on proper management and reporting of a patient’s chronic conditions. We always advise clients to assess all chronic conditions at least twice per year: once in the period between January 1st and June 30th and again … Read Full Post

Tagged chronic conditions, cms-hcc model, documentation, health risk assessment, hospital admissions, medicare risk adjustment, mra, patient visit, pcp assessment, reimbursement, risk adjusted reimbursement |

Tag Archives: cms-hcc model

A Moment of Silence for the Sunsetting MRA Program – Part 3

A Moment of Silence for the Sunsetting MRA Program – Part 2

A Moment of Silence for the Sunsetting MRA Program – Part 1

The Balanced MRA Approach

A Fundamental Disconnect of Risk Adjustment Documentation

2014 Holds Big Changes for the CMS-HCC Model

Maximizing the first patient visit of a period

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