Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...
The Biden administration is proposing to increase Medicare Advantage (MA) and Part D plan payments by 1.03% for 2024 amid other changes to the programs’ risk adjustment model. The Centers for Medicare ...
Medicare Advantage is the dominant Medicare delivery system, now covering 54% of all Medicare enrollees. With the increase in enrollment and federal spending, however, has come increased scrutiny from ...
Faced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care ...
The growth of the Medicare Advantage (MA) program to over half of eligible Medicare beneficiaries has made MA payment a salient part of Medicare policy discussions. Those discussions often focus on ...
As a result of insurers “upcoding” patient diagnoses, the Centers for Medicare and Medicaid Services (CMS) overpaid Medicare Advantage (MA) by $50 billion (or 13 percent) in 2024, according to the ...
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