Related: Epic, Salesforce and the race to build AI agents Uncovering problems through health risk assessments not only allows insurers and providers to intervene early, it also enables Medicare ...

Medicare Advantage (MA) companies receive higher risk-adjusted payments from the Centers for Medicare & Medicaid Services (CMS) for enrollees who are sicker, which helps to ensure that plans ...

Medicare is also a form of monetizing and transferring risk. My payroll taxes are transferring much of the risk of my health care costs, once I am older or if I become disabled, to the U.S ...

A recent report [1] released by the U.S. Department of Health & Human Services Office of Inspector General found that billions in Medicare payments were paid out for risk assessments performed by ...

With Medicare ... risk through the addition or inflation of diagnoses, may threaten payment rate integrity. One factor that may play a role in escalating coding intensity is health risk ...

Some insurers providing Medicare Advantage plans used chart reviews and health risk assessments to drive up federal payments to the tune of billions of dollars, according to a study by the ...

Guess who just got dinged after an audit for not doing a risk assessment adequately? It was none other than The Centers for Medicare & Medicaid Services (CMS). The Department of Health and Human ...

The analysis, led by researchers at Brown University, dug into encounter data from 2019 and found that 44.4% of Medicare Advantage beneficiaries had received at least one health risk assessment.

Under MA, insurers contract with the government to manage the care of Medicare beneficiaries. The plans receive monthly payments that aim to approximate their costs, adjusted for enrollees ...