Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...

Faced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care ...

The main difference between MedPAC and CMS estimates of uncorrected coding intensity is that MedPAC’s estimate accounts for the upward trend in coding intensity. The growth of the Medicare Advantage ...

Part 1 below covers key tradeoffs and the first two of four categories of strategies that have been advanced to improve risk adjustment in Medicare Advantage. Part 2 tomorrow will cover the remaining ...

This is my hands-on evaluation of 10 risk adjustment platforms for value-based care teams preparing for 2026 Medicare ...