Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...
On September 10, 2018, the United States Government Accountability Office (GAO) published a report titled “Medicare Advantage: Benefits and Challenges of Payment Adjustments Based on Beneficiaries’ ...
In an individual insurance market, plan payments are risk-adjusted to limit distortions in plan offerings that arise from incentives to select favorable risks. With this objective in mind, risk ...
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 ...
On April 28, 2022, the U.S. Department of Health and Human Services (HHS) posted the 660-page final 2023 Notice of Benefit and Payment Parameters alongside a press release, a fact sheet, the final ...
The Centers for Medicare and Medicaid Services is proposing to phase-in changes to the way it calculates risk adjustment payment to Medicare Advantage plans. Starting in 2020, CMS will calculate ...
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