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Medicare Advantage: Changes Improved Accuracy of Risk Adjustment for Certain Beneficiaries: Gao-12-52 (in English)
U. S. Government Accountability Office ( ; U. S. Government Accountability Office ( (Author)
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Bibliogov
· Paperback
Medicare Advantage: Changes Improved Accuracy of Risk Adjustment for Certain Beneficiaries: Gao-12-52 (in English) - U. S. Government Accountability Office ( ; U. S. Government Accountability Office (
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Synopsis "Medicare Advantage: Changes Improved Accuracy of Risk Adjustment for Certain Beneficiaries: Gao-12-52 (in English)"
The effect of CMS's revised community model on payment accuracy varied for the high-risk groups studied. Specifically, compared with the current community model, the revised community model slightly reduced the accuracy of MA payment adjustments for beneficiaries with multiple chronic conditions by $164, or about 1 percent of average actual expenditures. For beneficiaries with low income, the accuracy of the revised and the current community models was similar: estimates differed by $5, or less than 0.1 percent of average actual expenditures. For beneficiaries with dementia, the revised community model substantially improved the accuracy of MA payment adjustments by $2,674, or about 16 percent of average actual expenditures.
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