The HEALS Academy

#CMS Update on MA Encounter Data & Risk Adjustment ?? "Release of Medicare Advantage Encounter Data Submission Performance Report, Q4 2024" "Submission Performance Reports have been sent to Medicare Advantage Organizations (MAOs) since 2019 to help plans review instances where their encounter data submission patterns appear particularly low and for which technical assistance and feedback from CMS may be appropriate. The Medicare Advantage Encounter Data Submission Performance Report for Q4 2024 are available at: HPMS Home Page > Risk Adjustment > Encounter Data > Submission Performance> 2025 February Update If you have questions about your Submission Performance Report, please email?[email protected]?with the subject line “Encounter Data Submission Performance Report, Q4 2024 Update.”" ??Reshare to your audience. ??Follow to learn more.

?? ?????? ?????????? ?????????????? ?????????? ???? ?????? ??????. Episode 18: Medicare Advantage Stakeholders To Know ?????????? ??????????: No. 1 - #AHIP Check out the full video here: https://lnkd.in/eb7biw7Q ??Reshare with your network. ??Follow to not miss anything.

???????????? ?????????????????? Select Your Answer from the Poll. ???????????? ???????????? I ???????? an accepted record, make it no more, Linked to the past in EDS, like a closed door. A special number marks my fate, Look at CLM05-3, you'll find my trait. What am I? Select Your Answer from the Poll. ?? Follow to learn more. ?? Reshare with your network. ?????? Learn More on YouTube @TheHEALSAcademy

?? ?????? ?????????? ?????????????? ?????????? ???? ?????? ??????. ?????????????? ????: Mastering EDPS Beneficiary Errors ?????????? ??????????: EDPS Error Code: Beneficiary Not Enrolled in MAO for DOS Check out the full video here: https://lnkd.in/eXBW6GB2 ??Reshare with your network. ??Follow to not miss anything.

???????? ???? ?????? ?????????? ???????????????? “Blending” has been CMS’ approach ? of transitioning changes in payment policies, easing the effect of the changes. The Risk Adjustment (RA) blending can be of: ? Data sources only (e.g. RAPS and ED) ? Payment Models only (e.g. V24 and V28). ? Or Both (e.g. 2017 CMS-HCC and 2024 CMS-HCC). You can see how complex this can be Especially without adequate understanding! From PY2016, CMS is proposing to put PACE Program’s risk adjustment payment on a blend schedule. [1] ???? ???????? - 2017 CMS-HCC Model: 90% - 2024 CMS-HCC Model: 10% ???? ???????? - 2017 CMS-HCC Model: 75% - 2024 CMS-HCC Model: 25% ???? ???????? - 2017 CMS-HCC Model: 50% - 2024 CMS-HCC Model: 50% ???? ???????? - 2017 CMS-HCC Model: 0% - 2024 CMS-HCC Model: 100% Not only is the data source changing (RAPS, ED, and FFS vs. ED and FFS) The model is changing (2024 CMS-HCC model). What strategies have your team implemented successfully? to stay on top of MA Risk Adjustment blendings? If you don't mind sharing it in the comments to learn from you ↓ ?? Reshare if you found this insightful. ?? Follow for actionable Medicare Advantage insights. [1] https://lnkd.in/evjgpAPk

???????????? ?????????????????? Check comments for answer options ↓ Drop your answer in the comment ???? :) ???????????? ???????????? I’m like a snore, a sleepy display, Tracking combined supplemental benefits way. In PWK06, I complete the SBSC code, With z’s mark the reporting mode. What Am I? Drop your answer in the comment ???? :) Check comments for answer options ↓ ??Reshare with your network. ??Follow to learn more.