This week, the Centers for Medicare & Medicaid Services (CMS) released earlier than usual their proposal for contract year 2022 to calculate risk scores for Medicare Advantage (MA) payments using only encounter data submitted by MA organizations and the 2020 CMS Hierarchical Conditions Categories (HCC) model. The intent of risk adjustment is to ensure that payments to MA plans reflect the relative risk, or characteristics and health conditions, of the enrollees. Research has found lower average risk scores for beneficiaries served by rural providers than urban, which is contrary to extensive research showing rural populations are less healthy than urban. Read more here.
