Research Report Using Encounter Data in Medicare Advantage Risk Adjustment
Laura Skopec, Bowen Garrett, Stephen Zuckerman, Douglas Holtz-Eakin, Christopher Holt, Tara O'Neill Hayes
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The Centers for Medicare & Medicaid Services (CMS) have been collecting encounter data from Medicare Advantage (MA) plans since 2012 and previously announced plans to use that data to reestimate the MA risk adjustment model. This change would make risk scores more accurately reflect the relative costs of providing care in MA, but likely effects on the broader MA system are unclear. The Urban Institute and the American Action Forum convened a one-day summit to discuss the policy, technical, and operational issues facing CMS as it considers this policy change.

Click here for further available background on MA risk adjustment.

Research Areas Health and health care
Tags Health care delivery and payment
Policy Centers Health Policy Center