Inside Angle

From 3M Health Information Systems

Tag: Medicare Advantage

Blog Post

Documentation and coding for HCCs in the wound care setting

July 12, 2021 / By Bobbie Starkey

As Medicare Advantage (MA) organizations report chronic disease conditions using ICD-10-CM encounter data to the Centers for Medicare and Medicaid Services (CMS) for use in the hierarchical condition category (HCC) […]

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Red Flag: OIG chart reviews of Medicare Advantage records raise concerns. Billions misspent?

February 14, 2020 / By Barbara Aubry, RN

Audits of Hierarchical Condition Categories (HCCs) have been performed for years as a way for Part C vendors (Medicare Advantage Organizations) to identify and support patients with complex needs. Higher […]

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How well does the CMS-HCC risk adjustment model predict future expense?

August 26, 2019 / By Samuel Young, MD

In my previous blog, “Demystifying Medicare Risk Adjustment,” I introduced the model that the Centers for Medicare and Medicaid Services (CMS) uses to predict future Medicare Advantage health expenditures—the CMS-HCC […]

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Medicare Advantage Advanced Notice for 2020: Key insights

February 13, 2019 / By Gretchen Mills

CMS has released the Advance Notice Parts I and II per the annual cycle of Medicare Advantage (MA) regulatory guidelines for the coming year. The Advance Notices provide the parameters […]

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Implications of the 2019 Medicare Advantage Part 1 Advance Notice

January 10, 2018 / By Gretchen Mills

On December 27, 2017, CMS published Part 1 of this year’s Medicare Advantage (MA) Advance Notice highlighting proposed changes in MA payments for 2019. CMS requires comments on this Part […]

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Think bipartisanship is dead? Two words – Medicare Advantage

February 1, 2017 / By Clark Cameron

Now that the masses have returned home from either the inauguration or protests in our nation’s capital, the Legislative and Executive branches have begun the daily scrum of governing. Given the polarized […]

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Is value-based insurance design the answer to reducing healthcare costs?

January 9, 2017 / By Steve Delaronde

Value-based insurance design (VBID) arrived in Washington, DC on the first day of 2017 when two of the largest federal government healthcare programs launched VBID demonstration programs.  The long-awaited Center […]

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A look back at popular blogs of 2016

December 29, 2016

Happy New Year and thank you to all our readers! Before we officially start 2017, catch up on five of Inside Angle’s most read blogs of 2016: Overcoming skepticism about […]

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Observations from the corner of Medicare Advantage and MACRA

November 2, 2016 / By Clark Cameron, Gretchen Mills

In early October, CMS surprised everyone and published the highly anticipated Final Rule on MACRA well ahead of schedule. A number of blogs have since provided high-level summaries of the […]

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MACRA Proposed Rule: What it means for Medicare Advantage

May 13, 2016 / By Gretchen Mills

On April 27, 2016, the Department of Health and Human Services issued a Notice of Proposed Rulemaking to implement key provisions of the Medicare Access and CHIP Reauthorization Act of […]

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Medicare Advantage Star ratings and dual-eligible demographic rate adjustments – What’s next?

April 22, 2016 / By Gretchen Mills

As a way to provide better care to beneficiaries and reduce federal health care expenditures, CMS rates each MA plan annually using the Star rating system. Star ratings are based […]

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Medicare Advantage 101

March 23, 2016 / By Clark Cameron

Over the past 10 years, Medicare Advantage (aka Medicare Part C) has become increasingly popular among beneficiaries and health plans. Seniors enjoy significant monthly cost savings over Original, fee-for-service Medicare, […]