"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, ...

Accurate risk adjustment isn’t just a box to check; it’s now a strategic lever. Hierarchical Condition Category (HCC) coding underpins risk scores that drive Medicare Advantage and other value-based ...

Health plan and industry trade groups are calling on the CMS to delay or not move forward entirely with proposed changes to the 2024 Medicare Advantage and Medicare Part D plans. The calls come as the ...

New legislation introduced in the Senate by Bill Cassidy, R-La., and Jeff Merkley, D-Or., seeks to curb overpayments to Medicare Advantage plans by imposing changes to MA risk adjustment. The No ...

Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...

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 ...