December 5, 2024 issue of RADAR on Medicare Advantage Acknowledging the growing prevalence of obesity in the U.S. and its existence as a chronic disease, CMS in its proposed Medicare Advantage and Part D rule for the 2026 contract year included a landmark provision to expand Medicare
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An insightful webinar exploring the power of collaboration between providers and health plans to achieve accurate risk-adjusted compensation. While providers and health plans may have different perspectives, there are numerous synergies and opportunities to use data analytics and drive value for patients. We delve into how providers
Read More →The Department of Health and Human Services, Office of Inspector General (OIG) continues to actively audit Medicare Advantage Risk Adjustment programs, with a focus on diagnosis codes at “high risk of being miscoded.” Between Feb. 2021 and May 2023, OIG issued 25 audit reports that uncovered significant
Read More →A high-performing risk adjustment member engagement program is crucial for healthcare organizations to accurately assess and document the health status of members. Here are four steps for health plans to take now that will enhance risk score accuracy, improve care coordination and achieve better outcomes. Clearly Identify
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