We help health plans and risk-bearing providers improve outcomes across their risk adjustment and quality programs.
As healthcare organizations continue adapting to evolving regulatory requirements, increased audit activity, and shifting quality measures, the ability to leverage complete, connected clinical data has become increasingly important. During Advantmed’s recent webinar, The Power of One Record: Maximizing Data to Meet New Demands, industry leaders explored how organizations can maximize the value of a single… Continue reading The Power of One Record: Maximizing Data to Meet New Demands
On April 6, CMS released the Final Notice for Contract Year 2027 Medicare Advantage and Part D payment policies, outlining updates to rates, risk adjustment, Star Ratings, and Part D redesign. While the final notice provides modest financial relief compared to earlier expectations, it reinforces CMS’s continued focus on payment accuracy, data integrity, and long-term… Continue reading CMS Final Notice 2027: What Plans Need to Know
The first full year of V28 is behind us. What did we actually learn? When CMS introduced V28, many organizations approached it as a model update, something to adapt to, optimize around, and eventually stabilize. A year into operating under the new model, a different reality has emerged. V28 was not just a recalibration. It… Continue reading V28 Fully Realized: What Health Plans Learned and What Comes Next
On January 26, 2026, the Centers for Medicare & Medicaid Services (CMS) released the 2027 Advanced Notice for Medicare Advantage (MA) plans, detailing proposed changes to MA capitation rates and Part C and Part D payment policies. The updates reflect CMS’s continued focus on payment accuracy, data integrity, and alignment with Original Medicare, with meaningful implications for… Continue reading 2027 CMS Advance Notice: Risk Adjustment and Quality Impacts for Medicare Advantage Plans
