Using data from 632 primary care practices, the authors show that the CMS Practice Assessment Tool has adequate predictive validity for participation in alternative payment models. Objectives: To ...

The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses.

CMS released proposals to update cardiovascular disease risk assessment and risk management services. The organization proposed coding and payment for an atherosclerotic cardiovascular disease risk ...

Medicare Advantage organizations may be improperly using health risk assessments to increase risk-adjusted reimbursement, according to a report HHS’ Office of Inspector General issued in September.

Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

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 ...

Some Care Compare information used by consumers to evaluate nursing homes is too old, and, in some cases, the Centers for Medicare & Medicaid Services needs to add more information to make data more ...

Medicare covers fall risk assessments during routine preventive visits for beneficiaries enrolled in Part B. If you have a history of recent falls or issues with walking and balance, you may be a ...

During a Medicare annual wellness visit, a healthcare professional may include a Social Determinants of Health Risk Assessment. This helps healthcare professionals determine whether there are ...