Best Practices for Health Plans to Run a Profitable & Compliant Risk Adjustment Program
Healthcare Plans are in constant flux, making it vital for Medicare Advantage Organizations (MAOs) and medical groups to
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Healthcare Plans are in constant flux, making it vital for Medicare Advantage Organizations (MAOs) and medical groups to
Are you ready for major changes impacting your healthcare costs in 2025? Even though it’s several months off,
In the ever-evolving Medicare Advantage risk adjustment landscape, understanding the shifts and developments is crucial for staying competitive
In the intricate world of Value based care, where precision and accuracy can make all the difference, one
Introduction How CMS Star Ratings are assessed The Centers for Medicare & Medicaid Services releases its quality Star
As the healthcare landscape evolves, the transition to the CMS-HCC (Hierarchical Condition Category) Model V28 represents a significant
Between 2024 and 2025, payments to Medicare Advantage plans are anticipated to increase by an average of 3.70
Introduction The Hierarchical Condition Category (HCC) risk adjustment model, initially introduced by CMS in 2004, serves as a
CMS UNVEILS THE PROPOSED FINAL RULE FOR MEDICARE ADVANTAGE IMPACTING HEALTH PLANS, PROVIDERS & PATIENTS. The 724-page final
As value-based care providers and organizations aim to ensure accurate risk adjustment for Medicare reimbursement, understanding strategies to mitigate audit
Ever wonder how healthcare plans balance their premiums despite enrolling individuals with varying health risks? Enter Risk Adjustment – A
Balancing financial sustainability and high-quality patient care in value based healthcare is challenging, especially with disparities exacerbated by current reimbursement
Healthcare Plans are in constant flux, making it vital for Medicare Advantage Organizations (MAOs) and medical groups to keep their
Are you ready for major changes impacting your healthcare costs in 2025? Even though it’s several months off, Medicare is
In the ever-evolving Medicare Advantage risk adjustment landscape, understanding the shifts and developments is crucial for staying competitive and effective.
In the intricate world of Value based care, where precision and accuracy can make all the difference, one critical aspect
Making a choice: overburdening or outsourcing? Do you find yourself overwhelmed by submission deadlines? Do you struggle with managing the
HCC coding is a critical component of risk adjustment in value based care. Understanding it’s basics is essential for healthcare