Since risk adjustment’s introduction in the Medicare Advantage (MA) program, the Centers forshutterstock_169176878-webinar-button.jpg Medicare and Medicaid Services (CMS) has calculated risk scores using diagnoses submitted by MA plans in the Risk Adjustment Processing System (RAPS) format. However, CMS is moving away from the RAPS format to 837 encounter data (EDS) for Medicare risk adjustment factor determination. Beginning in 2016, CMS will blend encounter data-based risk scores with RAPS-based risk scores and eventually completely replace RAPS data.
It is now a business imperative for plans to have a robust encounter submission strategy in place to preserve revenue in 2016 and improve revenue in the future. Click here to view this free webinar originally presented to members of ACAP on the move to encounter data, how this could affect plans, and how to build a strategy that ensures success.