Medicare Advantage Risk Adjustment
Expert articles and analysis related to medicare advantage risk adjustment.
AI Summary ā Last 7 Days
In the last week, developments around Medicare Advantage and Accountable Care Organizations (ACOs) have highlighted ongoing tensions in risk adjustment and financial performance. Aetna has agreed to a substantial settlement of $117.7 million for inaccuracies in diagnosis coding for its Medicare Advantage enrollees, underscoring risks associated with compliance and financial accountability in risk adjustment practices. Simultaneously, new initiatives are emerging, including the launch of an innovative Medicare ACO by OCHIN and C3, which aims to leverage data-driven approaches to enhance value-based care delivery. Additionally, organizations are increasingly focusing on predictive cost modeling as a critical strategy within ACO structures to improve financial performance and patient outcomes, as noted by [TipRanks](https://news.google.com/rss/articles/CBMivwFBVV95cUxNLUs0R0FURzFWVnh2R0xtb3NCc1A4aGMzVUxzTXdGVWpFcnNvbjRQZ2hoeEwwNUw3dUIxZXhwT0VMSU5WMzhBWVg5ejA1MnV1eVUwZmRWTWhvR2hFX1Z0ZW1oQ3pYZmhmZ25uMUI3TUE5OEYtTzItZjFKZF9WLTBERlhjR2ZUdDl0RUFuSzBLV2ZaTWtsbUZYaXRFREpkdk
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