Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...
The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses.
On a day when health insurers were reeling from the Trump administration proposing minimal increases to Medicare Advantage (MA) rates next year and a tightening of risk adjustment rules, a top CMS ...
The CMS has proposed several key changes for 2027, to make sure Medicare "works better for the people it serves." ...
16don MSN
Report: UnitedHealth Group used 'aggressive tactics' in Medicare Advantage risk assessments
A Senate report accuses UnitedHealth Group of turning Medicare Advantage risk adjustments into a profit strategy.
In 2024, the first year Medicare paid for services that address patients’ health-related social needs, most care came from ...
Iowa, dove into 50,000 pages of documentation from UnitedHealth for the new report, which accuses the company of maintaining ...
Physician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.
According to the Wall Street Journal, a US Senate committee has reported “aggressive” risk-adjustment tactics in Medicare Advantage at UnitedHealth Group UNH, although no formal recommendations were ...
Medicare may use questionnaires at various times to collect information. One of the main questionnaires is the Medicare Current Beneficiary Survey (MCBS). Medicare may ask an individual to fill in a ...
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