CMMI’s new experiment will improve outcomes for volunteers and digital health companies, not the sickest seniors or primary care practices.

"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 ...

Among other provisions, the Rate Announcement includes the following: Payment Changes/Growth Rates: The effective growth rate for 2024 MA non-End-Stage Renal Disease (ESRD) rates is 2.28%, a slight ...

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 ...

On March 31, 2023, CMS finalized its Announcement of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage (MA) Capitation Rates. One of the most significant changes for 2024 is ...

Medicare Advantage (MA) is privately administered health care insurance for seniors and persons with disabilities. The program has grown rapidly and now covers more than half of Medicare-eligible ...

On April 1 st, the Centers for Medicare & Medicaid Services (“CMS”) announced its Medicare Advantage (“MA”) Capitation Rates and Part C and Part D Payment Policies for Calendar Year (“CY”) 2025. This ...

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 ...

The Centers for Medicare & Medicaid Services (CMS) recently released its 2026 Medicare Advantage (MA) Rate Announcement, projecting a 5.06% average increase in payments to MA plans — a significant ...

Medicare Advantage plans are getting a 5% payment increase, which is above the anticipated 4.3% released in the Advance Notice. The Centers for Medicare and Medicaid Services issued the rate ...