Risk Adjustment & Benchmarking
Expert articles and analysis related to risk adjustment & benchmarking.
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New USC research on Medicare Advantage dementia coding finds heterogeneous plan/provider responses to risk-adjustment reform, reinforcing that CMS-HCC changes can shift diagnosis behavior—not just measured morbidity—with direct implications for MA benchmarks, coding audits, and provider contracts tied to risk score capture (USC dementia risk-adjustment study
Related Articles
Research from University of Southern California Reveals New Findings on Dementia (Heterogeneous responses to risk-adjustment reform: evidence from dementia diagnosis in Medicare Advantage): Neurodegenerative Diseases and Conditions – Dementia
Research from University of Southern California Reveals New Findings on Dementia (Heterogeneous responses to risk-adjustment reform: evidence from dementia diagnosis in Medicare Advantage): Neurodegen...
ACA Marketplace Insurer Exits Are Reshaping the Market. Here’s How Health Plans Should Respond.
Opportunity After Exit: Strategic Responses to ACA Exits Key Takeaways Health insurers participating in the individual Affordable Care Act (ACA) Marketplace are facing one of the most challenging oper...