Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

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 ...

As CMS-HCC V28 fully takes effect in 2026, healthcare organizations face a structural reset in risk scoring. Planning ...

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 ...

Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with Penguin Ai's HCC Coding & Risk Adjustment Snowflake Native App PALO ALTO, Calif., Jan.

One of the most significant changes for 2024 is the introduction of version 28 of the Risk Adjustment Model, increasing the number of HCCs from 86 to 115, changing the name and numbering of HCCs, the ...

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 ...

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 ...

Apixio Inc., the data science company for healthcare, announced availability of the AI-powered solution to help health plans and provider organizations to undertake internal audits of their risk ...

CVS Health Corporation (NYSE:CVS) is one of the best healthcare stocks to buy for 2026. On January 27, BofA Securities cut ...

Among other provisions, the Rate Announcement includes the following updates: MA Payment Changes/Growth Rates: The effective growth rate for 2025 MA non-end-stage renal disease (ESRD) rates is 2.33%.