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Top News In Hierarchical Condition Categories Today - Breaking & Trending Today

Proposed Medicare Advantage cuts would increase premiums, decrease growth rate, BMA finds

Insurers expect that the Centers for Medicare and Medicaid Services' recent advance notice for Medicare Advantage and Part D plans for the 2024 coverage year will result in a 2.27% cut to plans if finalized, and this could have a negative impact on members' premiums and benefits, as well as slow MA growth, according to a new Avalere study commissioned by Better Medicare ....

United States , Los Angeles , Mary Beth Donahue , Centers For Medicare , Medicaid Service , Better Medicare Alliance , Better Medicare Alliance President , Beth Donahue , Medicare Advantage , Better Medicare , Hierarchical Condition Categories ,

Natural language processing creates an audit trail for risk adjustment

The best way for insurers to make sure they're in compliance with the mandates of risk adjustment is to use natural language processing for accurate documentation and auditing, according to Dr. Calum Yacoubian, director, Healthcare Strategy, Linguamatics, an IQVIA company that offers an NLP-based AI platform. Last week's publication of the final rule for risk adjustment data ....

United States , Calum Yacoubian , Centers For Medicare , Human Services Office Of Inspector , Medicaid Services , Healthcare Strategy , Medicare Advantage Organizations , Hierarchical Condition Categories , Medicare Advantage , Human Services Office , Inspector General , Risk Adjustment Data Validation ,

More payer/provider transparency at point of care improves risk, quality

Increased data transparency between health plans and providers on care and coding gaps results in higher compliance, process improvement and positive behavior changes among network providers, according to a new report from information technology company IllumiCare. The report demonstrates, across multiple plans, that placing previously unavailable information on quality gaps, ....

Hierarchical Condition Categories , Accountable Care Organizations , Medicare Advantage , Smart Ribbon ,

Study: Increased Transparency Between Payers and Providers at the Point-of-Care Improves Risk Capture and Quality Measures

Increased data transparency between health plans and providers on care and coding gaps results in higher compliance, process improvement. ....

Increased Transparency Between Payers , Point Of Care Improves Risk Capture , Should Know , Hierarchical Condition Categories , Care Via Increasing Data , Medicare Advantage , Smart Ribbon ,

J.P. Morgan Healthcare Conference Day 2 Summary

I was listening carefully to the health plan numbers announced for enrollment and what trends they were seeing as to growth in Medicaid members versus commercial and Marketplace enrollment. Thankfully, none of the health plans reporting shared troubling numbers. ....

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