ACHP’s concern is that larger national plans are stifling competition for the smaller insurers. Smaller local plans are ...

Risk-adjustment reform should address concerns related to both coding intensity and predictive accuracy. We recommend that reforms to risk adjustment should accomplish key goals including the ...

Your members are sicker than your risk scores reflect. Not because diagnoses don’t exist—they’re buried under unstructured ...

To partially correct for overpayments due to coding, the Centers for Medicare and Medicaid Services (CMS) applies a coding intensity adjustment of 5.9 percent to MA risk scores.

The research from the Alliance for Community Health Plans adds to existing evidence that major insurers are unfairly ...

With all the changes to risk adjustment coding specifically, such as constrained coefficients for some hierarchical condition categories, individual coders will need additional education that ...

CMS is proposing a 1.03% increase to Medicare Advantage and Part D plan payments for 2024 amid several changes to the risk adjustment model.

The Alliance of Community Health Plans (ACHP) is making the case that risk adjustment in Medicare Advantage (MA) needs a ...

For risk adjustment, Cavo offers a next-generation coding solution purpose-built to support Medicare Advantage, Medicaid, and Commercial risk programs.

For risk adjustment, Cavo offers a next-generation coding solution purpose-built to support Medicare Advantage, Medicaid, and Commercial risk programs.