CMS to audit every MA plan — Why prospective risk adjustment is now mission-critical
CMS just raised the stakes: All Medicare Advantage contracts will now be audited each year — a move signaling the agency's strong push to tighten oversight and recoup overpayments. Retrospective models are no longer enough.
This whitepaper outlines how forward-thinking health plans are shifting to prospective risk adjustment to close gaps earlier, improve HCC capture and avoid audit risk. It explores tech-enabled strategies that support network providers at the point of care — streamlining documentation, strengthening quality and enabling year-round gap closure.
Inside, you'll learn:
This whitepaper outlines how forward-thinking health plans are shifting to prospective risk adjustment to close gaps earlier, improve HCC capture and avoid audit risk. It explores tech-enabled strategies that support network providers at the point of care — streamlining documentation, strengthening quality and enabling year-round gap closure.
Inside, you'll learn:
- How prospective strategies can boost audit preparedness, star ratings and revenue
- Why EHR-integrated workflows and embedded analytics drive faster, more accurate HCC capture
- What effective provider engagement looks like and how it improves alignment and performance
Please fill out the form to download the whitepaper.