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CORAL: A roadmap for ACA

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Medicare Advantage hierarchical condition categories: Targeting chart reviews

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By Corey Nathan Berger, Eric P. Goetsch | 31 January 2011

A key to the success of a Medicare Advantage (MA) plan is ensuring that the plan's payment from the Centers for Medicare and Medicaid Services (CMS) appropriately reflects the health status of the plan's population. This article discusses the data that MA plans should be reviewing, as well as main methodological considerations and other issues that can affect payments to MA plans.