Using Encounter Data in Medicare Advantage Risk Adjustment

Research Report

Using Encounter Data in Medicare Advantage Risk Adjustment

Abstract

The Centers for Medicare & Medicaid Services (CMS) has been collecting encounter data from Medicare Advantage (MA) plans since 2012, and previously announced plans to use that data to re-estimate 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 is it considers this policy change.

Click here for further available background on MA risk adjustment. (Leaving Urban's website)

Research Area: 

Centers

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