Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...
The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses.
Medicare has launched a six-year pilot program that could eventually transform access to health care for some of the millions ...
In 2024, the first year Medicare paid for services that address patients’ health-related social needs, most care came from ...
On a day when health insurers were reeling from the Trump administration proposing minimal increases to Medicare Advantage (MA) rates next year and a tightening of risk adjustment rules, a top CMS ...
According to the Wall Street Journal, a US Senate committee has reported “aggressive” risk-adjustment tactics in Medicare Advantage at UnitedHealth Group UNH, although no formal recommendations were ...
Physician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.
MINNETONKA, Minn. — UnitedHealth Group used aggressive tactics to maximize it's Medicare Advantage risk adjustment scores, a new report alleges. The U.S. Senate Committee on the Judiciary published ...
Medicare may use questionnaires at various times to collect information. One of the main questionnaires is the Medicare Current Beneficiary Survey (MCBS). Medicare may ask an individual to fill in a ...
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