What’s Up With MIPS? New MVPs Framework Could Bring Sweeping Changes

Posted in GeBBS Healthcare Solutions, Inc.

The Merit-based Incentive Payment System (MIPS) – which is just one element of the government’s proposed alternative payment models (APMs) designed to reduce healthcare costs – has been a moving target since the concept was introduced in 2015. Just last week, the Centers for Medicare & Medicaid Services outlined a new proposal to its Medicare …

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It’s Working – CMS Report Concludes the Effectiveness of Risk Adjustment

Posted in GeBBS Healthcare Solutions, Inc.

In late June, the Centers for Medicare & Medicaid Services released data demonstrating that its Risk Adjustment Program – developed as part of the Affordable Care Act just five years ago – is working just as planned. What was the plan? To prevent payers from developing plans intended to attract healthier patients and to incentivize …

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Accurate RAF Scores Could Mean Billions in Savings for Medicare

Posted in GeBBS Healthcare Solutions, Medicaid, Medicare

A recent study published by the Kaiser Family Foundation sheds light on a complex issue – how to determine the real or predicted cost of care for Medicare Advantage plan members when establishing RAF scores is based on the inexact science of provider documentation. The study released this spring indicated that those who were enrolled …

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