CMS-HCC Model V28 is set to be introduced in 2026 and will introduce a lot of changes related to risk adjustment. Providers have to cope with new documentation, coding changes, and workflow changes. Among the key effects are the increased clinical-coding alignment, the increased interoperability requirements, and the support of documentation by AI. The first step that organizations should...
The Medicare Advantage Program is a better value based on coordinated care, cost reduction, and quality improvement. Plans perform better with HCC coding to provide a precise risk assessment, star ratings to measure quality, and integrated EHRs to facilitate the coordination of care. There are other benefits to the members, such as prescription drug coverage, wellness plans, and reduced...
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