A growing range of policy discussions correctly assert that the current Centers for Medicare and Medicaid Services’ (CMS) risk-adjustment system needs modernization, reflecting its long history and ...

Accurate HCC coding is critical for patient risk adjustment, as it directly impacts reimbursement models and financial sustainability in value-based care. However, studies indicate that as many as ...

Claims data, which form the foundation of risk adjustment in payment for health care services, may reflect efforts to capture more—or more severe—clinical conditions rather than true changes in health ...

Inaccurate HCC coding can lead to significant financial implications and variability in Risk Adjustment Factor scores. A new infographic released by PYA illustrates why coding accuracy is paramount ...

"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, ...

Review Proposed Changes for Medicare Advantage Plans in 2024 Discuss the change from Version 24 to Version 28 and the impact on Risk Adjustment Calculation Methodology Explain how Fee-for-Service will ...

United States, 7th Aug 2024 - In the realm of healthcare, precision is everything. The accuracy of Hierarchical Condition Category (HCC) risk scores plays a pivotal role in the financial health of ...

(MENAFN- Robotics & automation News) The Evolution of CMS Risk Adjustment: Past, Present, and Future Early History of Risk Adjustment in Healthcare This blog explores the basics and early history of ...

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 end-to-end solution enables payers and providers to run patient risk adjustment programs in-house, lowering costs and improving accuracy LEWES, Del., April 22, 2025 (GLOBE NEWSWIRE) -- John Snow ...