Publications
Read their latest work
Video
It’s worth the risk: Medicare Advantage risk adjustment hot topics
15 March 2023 - by Jason Choi, Karin Cross, Rebecca Gergen
Our presenters discuss risk model changes for the 2024 bid year and beyond as well as considerations in risk score coding accuracy in light of the final RADV audit rule.
Article
High-level impacts of the proposed CMS-HCC risk score model on Medicare Advantage payments for 2024
28 February 2023 - by Rob Pipich, Karin Cross, Michael Rothschild
The 2024 Medicare Advantage (MA) Advance Notice includes a proposal to implement a clinically revised risk score model to be used for MA payments for calendar year 2024.
Article
Medicare Advantage Risk Adjustment Data Validation (RADV) final rule
08 February 2023 - by Rob Pipich, Karin Cross, Michael Rothschild
The RADV final rule has significant implications for how Medicare Advantage plans are paid. Learn more about how the final rule may affect MA stakeholders.
Article
How far will Medicare Advantage 2021 revenue and risk scores drop if seniors stop going to the doctor?
20 October 2020 - by Rob Pipich, Karin Cross, Deana Bell
This paper presents nine scenarios intended to illustrate a range of potential outcomes on 2021 Medicare Advantage and Part D risk scores.
Article
What's driving the high risk score trend in the 2018 Advance Notice?
27 February 2017 - by Darcy Allen, Karin Cross, Rob Pipich
After calculating the Medicare fee-for-service risk score trends and Hierarchical Condition Category (HCC) changes using the Medicare 5% Sample, we determined that there are six key HCCs driving those trends.