The Centers for Medicare and Medicaid Services today released the final rule to change the methodology for the U.S. Department of Health and Human Services' risk adjustment data validation (HHS-RADV) ...

As the Centers for Medicare and Medicaid Services (CMS) approaches the goal of tying 90 percent of traditional Medicare payments to the value of care delivered, 1 risk adjustment—adjusting quality ...

If finalized, these proposals will generally take effect on January 1, 2025, unless otherwise noted. Both the individual and small group market risk adjustment system are based on a set of regression ...

HHS has released a final rule (pdf) on the standards related to reinsurance, risk corridors and risk adjustment under the Patient Protection and Affordable Care Act. Reinsurance, risk corridors and ...

The ASPE’s recommendation against adjusting outcome measures for social risk is based on the concern that adjustment would mask or excuse poor-quality care. We feel that this concern is misguided.

To maximize shared savings, mastering risk adjustment is a critical factor for Accountable Care Organizations (ACOs) participating in MSSP, ACO REACH, and other alternative payment models.

Analysts say HHS favors "models that make accurate predictions at the enrollee level within a sample population... that tend to miss the ranges of severity and spending within specific conditions like ...

Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.