Forging ahead after the Medicare Advantage RADV Final Rule
Here are three strategies Medicare Advantage plans should consider in light of the RADV Final Rule released by CMS in January 2023.
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Commercial and Medicare Risk Adjustment
Improve your prospective and retrospective risk adjustment results with these resources from Cotiviti, including white papers and articles written by our senior risk adjustment experts.
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How to build risk adjustment into your value-based care strategy
Learn practical approaches to execute risk adjustment strategies and drive program success in our on-demand RISE webinar.
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OIG risk adjustment compliance audit showcases 3 clear takeaways
Amid OIG scrutiny of Medicare Advantage risk adjustment coding practices, Cotiviti offers three takeaways for plans looking to strengthen their programs.
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Achieving risk adjustment excellence in the hyper-competitive Medicare Advantage landscape
Our new eBook explains the three opportunities for excellence that Medicare Advantage plans must pursue to excel in today's ultra-competitive marketplace.
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Understanding the 2022 CPT code changes %% Watch the on-demand webinar
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OIG report highlights beneficiary protections as Medicare Advantage program grows
As OIG raises concerns about beneficiaries' access to care, purposeful, informed decision-making will drive successful financial and clinical results for Medicare Advantage plans.
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Strategies to smooth the drag on average RAF scores during enrollment surges
Learn how analytics, prospective risk adjustment, and member engagement campaigns can effectively smooth risk scores when managing an influx of enrollees.
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Medicare Advantage risk adjustment in 2022: Driving to fierce and focused
Learn the three key areas that Medicare Advantage plans should bolster within their risk adjustment programs to excel in today's competitive environment while helping ensure premium accuracy.
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Tips from RISE National 2022 for risk adjustment success
RISE co-chair RaeAnn Grossman explains how Medicare Advantage plans can limit audit exposure and offers other risk adjustment advice for 2022.
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5 takeaways from the 2023 Medicare Advantage and Part D Final Rate Announcement
Medicare Advantage plans will see a major 8.5% increase in revenue from the final 2023 Medicare Advantage and Part D Rate Announcement released by CMS.
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Comprehensive Risk Adjustment solutions
Learn how Cotiviti's suite of prospective and retrospective Risk Adjustment solutions enable plans to illuminate the holistic health status of their member populations to achieve premium accuracy.
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CMS 2023 Advance Notice: Health equity takes center stage
Cotiviti leaders break down the 2023 Medicare Advantage and Part D Advance Notice as CMS prioritizes health equity measurement.
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RISE Webinar: Uniting risk adjustment, HEDIS, and Stars
Learn a "next best action" approach to analytics at the member level with the potential to deliver tangible impact for both risk adjustment and quality improvement programs.
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Q&A: Strategic payer initiatives at the intersection of risk and quality
By working in unison, risk adjustment and quality teams can better understand where care gaps exist and the most effective ways to deliver high-value care to disengaged or disenfranchised members.
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The three fundamentals of risk adjustment success
Risk adjustment—and the complex nature of the processes involved—is often misunderstood. Learn the fundamentals health plans must master to be successful.
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Mitigating the impact of COVID-19 on risk adjustment and quality scores
As routine medical services are cancelled or postponed due to COVID-19, prospective risk scores used to pay Medicare Advantage (MA) health plans in 2021 are trending lower than...
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10 tips for a seamless commercial risk adjustment program
Learn best practices to optimizing commercial risk adjustment revenues while maintaining total compliance.
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CMS 2022 Advance Notice: 4 key takeaways for MA plans
The public comment period has just closed for the calendar year (CY) 2022 Medicare Advantage (MA) and Part D Advance Notice recently released by the Centers for Medicare & Medicaid...
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Decoding the 2021 CPT code changes
Cotiviti's experts break down the >300 changes to the 2021 CPT code set, including a major overhaul to office and other outpatient E&M services.
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The evolution of DxCG, the gold standard in risk adjustment and predictive modeling
Updated in 2022 for DxCG's 25th anniversary, this is the story of the birth and evolution of one of the earliest and most accurate risk assessment and predictive modeling solutions in the industry.
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CMS releases ACA risk adjustment transfer payments and HRADV adjustments for 2019
The Centers for Medicare & Medicaid Services (CMS) recently released the health plan-specific 2019 benefit year risk adjustment transfer payments. As part of the Affordable Care Act...
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