July 19 2018 | 0 Comments | 147 reads Average Rating: 3

Poll Participants Weigh in On Risk Adjustment Model Readiness

by SCIO Health Analytics in Risk Adjustment

During a recent webinar entitled Call Letter Chat: Understanding and Planning for CMS’ Policy Changes, Tom Peterson, Senior Vice President, and Pam Klugman, SCIO’s Risk Adjustment Expert, explained not only why it is important to understand all the details of the new Centers for Medicare and Medicaid Service's (CMS) Hierarchical Condition Category (HCC) Risk Adjustment Model outlined within the document but how to deal with these new developments as well.

Through an online poll, the webinar also provided attendees with the chance to express their opinions on the call letter’s details.

According to the call letter, the new CMS HCC Risk Adjustment Model will use a blend of encounter data processing system (EDPS), fee-for-service (FFS) and inpatient risk adjustment payment system (RAPS) data. Whether or not healthcare providers will be able to comply with this requirement remains to be seen – as less than half said that they currently reconcile RAPS and EDPS data.

The transition to the new risk adjustment model certainly seems to be weighing heavily on the minds of health professionals, as a large number categorized the transition as an ongoing project. Confidence in their ability to be ready, however, does not appear strong.

While CMS is transitioning to 100% EDPS by 2022, there’s always the possibility that healthcare organizations will be granted some leeway. Healthcare professionals are split pretty evenly down the middle as they hedge their bets on an extension.

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