The research from nonprofit payer group the Alliance for Community Health Plans adds to existing evidence that major insurers ...

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 ...

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

The transition to CMS V28 is more than a coding update—it’s a shift that challenges health plans to rethink their operational strategies, documentation standard ...

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.

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 ...

Talix has entered into a reseller agreement with NextGen Healthcare, Allscripts and Capstone Performance Systems to make Talix's risk-adjusted coding solution available to customers on the ...

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.