Becker's: CMS proposes risk adjustment updates to Medicare Advantage: 5 things to know

  1. Part 1 of the 2021 Advance Notice proposes changes to the Part C risk adjustment model and the use of encounter data.
  2. CMS proposes to calculate risk scores for 2021 by using 75% of the risk score calculated w/ the 2020 CMS-Hierarchical Condition Categories model & 25% of the risk score calculated w/ the 2017 version.
  3. CMS also proposed changes to how it uses encounter data
  4. or diagnostic information
  5. in the risk adjustment calculation process.
  6. CMS is taking comments on the changes through March 6
  7. 2020.
  8. Payment policies for 2021 will be finalized in an annual rate announcement scheduled for April 6.

Source: Becker's Hospital Review - https://www.beckershospitalreview.com/payer-issues/cms-proposes-risk-adjustment…

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