Analysts say HHS favors "models that make accurate predictions at the enrollee level within a sample population... that tend to miss the ranges of severity and spending within specific conditions like ...

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 ...

The Centers for Medicare and Medicaid Services is proposing to phase-in changes to the way it calculates risk adjustment payment to Medicare Advantage plans. Starting in 2020, CMS will calculate ...

Reintroducing Alzheimer disease and related dementias (ADRD) hierarchical condition categories (HCCs) into the Medicare Advantage (MA) risk-adjusted payment model was linked to improved care access ...

“Our latest product release is a testament to our commitment to provide healthcare organizations with on-demand risk scoring solutions in support of their reform initiatives,” said Diane Laurent, MARA ...