Medicare Advantage

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Value Based Insurance Design New Clinical Categories for MA Plans

The Centers for Medicare & Medicaid Services (CMS) is announcing refinements to the Medicare Advantage Value-Based Insurance Design (MA-VBID) model. Beginning January 1, Value Based Insurance Design Model for Medicare Part C018, CMS will add and to the clinical categories for which participants may offer benefits. CMS will also make adjustments to existing clinical categories and [...]

ICD-10 Readiness Compromised by ICD-10 Revenue Cycle, Analytics Vendors

We find that most analytics and revenue cycle companies are ignoring the future role coordinated medical coding will have, the transition to ICD-10, and the clinical documentation and processes on the revenue cycle. The ICD-10 transition will re-write the book on revenue cycle management (RCM). RAC audits and Electronic Medical Records (EMRs) will be subject to a new paradigm with ICD-10.