Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...

NEW YORK CITY, NY / ACCESS Newswire / June 1, 2025 / As healthcare payers face intensified regulatory oversight, rising healthcare costs, and the evolving complexities of risk adjustment, Black Book ...

The Medicare Advantage (MA) risk-adjustment system increases and decreases MA plan payments based on the health risks of their enrollees. The current system assesses health risk based on Hierarchical ...

Faced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care ...

In 2020 Medicare reintroduced Alzheimer’s disease and related dementias (ADRD) Hierarchical Condition Categories (HCCs) to risk-adjust Medicare Advantage and accountable care organization (ACO) ...