Three things to know:
1. CMS plans to increase payment rates to Medicare Advantage plans by 2.82 percent compared to last year.
2. CMS wants to apply a coding pattern adjustment of 5.9 percent to reflect differences in diagnosis coding between Medicare Advantage plans and fee-for-service providers. The adjustment is the minimum for coding pattern differences required by law.
3. As outlined in part one of the proposed rule, risk scores used to calculate payment to Medicare Advantage plans in 2022 would rely entirely on encounter data as the source of diagnoses. In the past, CMS has used a blend of encounter data and diagnoses submitted to its risk adjustment processing system.
More articles on payers:
Anthem’s profit falls 81% in Q3: 3 things to know
CMS issues coverage rules for COVID-19 vaccine: 10 things to know
UnitedHealthcare to send members kits with COVID-19 tests, Tamiflu
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
