The COVID-19 pandemic put a strain on the entire healthcare industry and, for risk adjustment in particular, the disruption caused by the pandemic resulted in both positive and negative effects. Here are several strategic items to help your organization prepare for the new year.
GHG recently hosted a webinar with Pareto Intelligence and Episource to discuss the best strategies to deploy to ensure that your upstream encounter data is accurate, complete, compliant, and ready for submission. Read a synopsis of the topics covered and watch the webinar recording on demand.
CMS recently released the 2022 Advance Notice Part 1, with a heavy emphasis on the shift from RAPS to EDS to calculate risk scores. Here’s what you should know.
The 2021 Medicare Advantage and Part D Rate Announcement finalizes the payment methodology and policies previously proposed by the Advance Notice. What’s been confirmed? Read this article for details.
Plan should start to take steps now to determine the impact of the blend and model change in the 2021 Advance Notice to their risk scores and revenue, and mitigate potential adverse impacts of the risk adjustment changes.
The Office of Inspector General (OIG) report on the use of chart reviews in Medicare Advantage risk adjustment raises a number of concerns for Medicare Advantage Organizations (MAOs). How can plans mitigate risk from chart review submissions and stay compliant with CMS risk adjustment guidelines to ensure complete and accurate reimbursement?
Even though the year has just begun, the healthcare industry is looking ahead to what…