Tag Archives: government accountability office

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 |

What We’re Reading – GAO recommends ending CMS bonus payment demonstration

From the GAO.gov website and different healthcare news websites. The Government Accountability Office (GAO), a nonpartisan investigative arm of Congress, recommends that CMS should discontinue its quality bonus program demonstration. The reasons are the budgetary impact, lack of data to … Read Full Post

Tagged center for medicare and medicaid services, cms, government accountability office, hedis program, medicaid cahps, medicare advantage bonus payment system, medicare advantage plans, mra, risk adjustment, the patient protection and affordable care act |

What We’re Reading – CMS overpaid Medicare Advantage (MA) by as much as $5.1 billion, according to the Government Accountability Office (GAO)

A report issued by GAO the week of March 7, indicates that CMS overpaid the MA program run by private companies by between $3.2 and $5.1 billion for the years 2010-2012. The overpayments were the results of CMS inadequately adjusting … Read Full Post

Tagged america's health insurance plans, center for medicare and medicaid services, cms, diagnostic coding, fee-for-service, gao, government accountability office, medicare advantage plans, overpayments, risk scores |

Tag Archives: government accountability office

2014 Holds Big Changes for the CMS-HCC Model

What We’re Reading – GAO recommends ending CMS bonus payment demonstration

What We’re Reading – CMS overpaid Medicare Advantage (MA) by as much as $5.1 billion, according to the Government Accountability Office (GAO)

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