Under the current Medicare Advantage (MA) risk-adjustment system, plans are incentivized to report diagnosis codes on enrollees’ medical claims reflecting additional and more severe health ...

The Department of Health and Human Services made headlines in October with a report detailing problems with health risk assessments used by Medicare Advantage insurers. The Office of Inspector ...

The lifetime cancer risk for all Americans is around 39%, and the Air Force's Health Risk Assessment found rates of 39.9% to 40.13% for men and women if they would have served anywhere from eight ...

With Medicare Advantage (MA) enrollment surpassing 50 percent of Medicare beneficiaries, accurate risk-adjusted plan payment rates are essential. However, artificially exaggerated coding intensity, ...