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Tag Archives: health risk appraisals
Some MA Companies Used Questionable Means to Drive MRA Payments
The Office of Inspector General (OIG) audits Medicare Advantage plans for, among other reasons, to assure they submit accurate and true information to the Centers for Medicare and Medicaid Services (CMS) and thereby, receive proper risk adjusted payments. The OIG’s … Read Full Post
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