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 ...

Recent actions from the Centers for Medicare & Medicaid Services (CMS) could help reduce the estimated $1.3 trillion in Medicare Advantage (MA) overpayments projected over the next decade.

Medicare Advantage (MA) is privately administered health care insurance for seniors and persons with disabilities. The program has grown rapidly and now covers more than half of Medicare-eligible ...

As CMS-HCC V28 fully takes effect in 2026, healthcare organizations face a structural reset in risk scoring. SOUTH PLAINFIELD, NJ, UNITED STATES, January 16, 2026 ...

On March 31, 2023, CMS finalized its Announcement of Methodological Changes for Calendar Year (CY) 2024 for Medicare Advantage (MA) Capitation Rates. One of the most significant changes for 2024 is ...

The MarketWatch News Department was not involved in the creation of this content. Joint customers can improve coding accuracy, strengthen compliant submissions, and strengthen RAF integrity with ...

Medicare Advantage plan payments are expected to get an 8.5% revenue increase for 2023. This is an increase over the 7.98% proposed in the February advance notice. The 2023 growth rate is set at 4.88% ...

SOUTH PLAINFIELD, NJ, UNITED STATES, January 16, 2026 /EINPresswire.com/ — As 2026 begins, healthcare leaders are no longer preparing for CMS-HCC V28, they are now ...