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

CMS proposes nearly flat Medicare Advantage payments for 2027, with a 0.09% increase and updated risk adjustment policies.

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

The CMS has proposed several key changes for 2027, to make sure Medicare "works better for the people it serves." ...

The CMS proposed modest payment growth for Medicare Advantage in 2027 and emphasized sustainability, accuracy, and simplicity.

For example, the No UPCODE Act, introduced by Senators Bill Cassidy (R-LA) and Jeff Merkley (D-OR), would eliminate the use of health risk assessments used to boost coding intensity and utilize two ...

UnitedHealth (UNH) and peers face significant margin risk after the CMS's 2027 Medicare Advantage rate proposal fell short of ...

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 ...

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 ...