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Risk Adjustment: It’s Time For Reform

A growing range of policy discussions correctly assert that the current Centers for Medicare and Medicaid Services’ (CMS) risk-adjustment system needs modernization, reflecting its long history and evolution. While refined over time, the same CMS-Hierarchical Condition Categories (HCC) risk-adjustment model has been used for nearly 20 years.

January 9th, 2023|Categories: Published Research|0 Comments

Risk Adjustment: It’s Time For Reform

A growing range of policy discussions correctly assert that the current Centers for Medicare and Medicaid Services’ (CMS) risk-adjustment system needs modernization, reflecting its long history and evolution. While refined over time, the same CMS-Hierarchical Condition Categories (HCC) risk-adjustment model has been used for nearly 20 years.

January 9th, 2023|Categories: Company News|0 Comments

Medicare Advantage Now Chosen By The Majority Of Minority And Low-Income Beneficiaries

Medicare Advantage (MA) has become increasingly popular over the past decade, with significant movement of beneficiaries away from traditional fee-for-service Medicare. While fee-for-service is still the option chosen by most beneficiaries (55 percent), some subsets of beneficiaries are much more likely to be enrolled in MA—specifically beneficiaries who are either [...]

December 21st, 2022|Categories: Published Research|0 Comments

Early Milestones on “Sync for Social Needs” Collaborative

Early Milestones on “Sync for Social Needs” Collaborative By Catherine Flatley, Senior Policy Advisor On December 6th, CMS announced the long-awaited update to a 2020 proposed rule, now called, “CMS 0057 Advancing Interoperability and Improving Prior Authorization Processes...” In addition to the new CMS rule, [...]

December 15th, 2022|Categories: Blog|0 Comments

Turquoise Health Partners with CareJourney to Integrate Provider Performance Metrics into the Turquoise Clear Contracts Direct-contracting Platform

Turquoise Health, an end-to-end price transparency platform, and CareJourney, a market leader in provider cost and quality data, today announced a partnership to integrate CareJourney provider performance metrics into the Turquoise Health Clear Contracts direct contracting platform. Including CareJourney’s provider performance indicators accelerates value-based care efforts, allowing Clear Contracts customers to easily vet potential providers based on cost and quality indicators.

December 8th, 2022|Categories: Company News|0 Comments
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