Inside Angle

From 3M Health Information Systems

Tag: Medicare Advantage

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The OIG and DOJ expect compliant HCC documentation

Jan. 31, 2022 / By Chris Berg, RHIA

As a clinical documentation integrity (CDI) and coding professional, I’ve often heard the statement: If it’s not documented, it wasn’t done. I have used this statement educating physicians and nurses […]

Sandeep WadhwaSandeep Wadhwa

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Three questions with Sandeep Wadhwa, MD, MBA: Medicare Advantage in 2022—Part 2

Jan. 18, 2022 / By Sandeep Wadhwa, MD, MBA, Kelli Christman

I sat down with 3M Health Information Systems Global Chief Medical Officer Sandeep Wadhwa, MD, MBA, to discuss clinical and financial risk management, and risk stratification with Medicare Advantage plans. […]

Sandeep WadhwaSandeep Wadhwa

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Three questions with Sandeep Wadhwa, MD, MBA: Medicare Advantage in 2022—Part 1

Jan. 6, 2022 / By Sandeep Wadhwa, MD, MBA, Kelli Christman

I sat down with 3M Health Information Systems Global Chief Medical Officer Sandeep Wadhwa, MD, MBA, to discuss new benefits for Medicare Advantage enrollees and the importance of accurate and […]

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Documentation and coding for HCCs in the wound care setting

July 12, 2021 / By Bobbie Starkey

As Medicare Advantage (MA) organizations report chronic disease conditions using ICD-10-CM encounter data to the Centers for Medicare and Medicaid Services (CMS) for use in the hierarchical condition category (HCC) […]

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Red Flag: OIG chart reviews of Medicare Advantage records raise concerns. Billions misspent?

Feb. 14, 2020 / By Barbara Aubry, RN

Audits of Hierarchical Condition Categories (HCCs) have been performed for years as a way for Part C vendors (Medicare Advantage Organizations) to identify and support patients with complex needs. Higher […]

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How well does the CMS-HCC risk adjustment model predict future expense?

Aug. 26, 2019 / By Samuel Young, MD

In my previous blog, “Demystifying Medicare Risk Adjustment,” I introduced the model that the Centers for Medicare and Medicaid Services (CMS) uses to predict future Medicare Advantage health expenditures—the CMS-HCC […]

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Medicare Advantage Advanced Notice for 2020: Key insights

Feb. 13, 2019 / By Gretchen Mills

CMS has released the Advance Notice Parts I and II per the annual cycle of Medicare Advantage (MA) regulatory guidelines for the coming year. The Advance Notices provide the parameters […]

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Implications of the 2019 Medicare Advantage Part 1 Advance Notice

Jan. 10, 2018 / By Gretchen Mills

On December 27, 2017, CMS published Part 1 of this year’s Medicare Advantage (MA) Advance Notice highlighting proposed changes in MA payments for 2019. CMS requires comments on this Part […]

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Think bipartisanship is dead? Two words – Medicare Advantage

Feb. 1, 2017 / By Clark Cameron

Now that the masses have returned home from either the inauguration or protests in our nation’s capital, the Legislative and Executive branches have begun the daily scrum of governing. Given the polarized […]

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Is value-based insurance design the answer to reducing healthcare costs?

Jan. 9, 2017 / By Steve Delaronde

Value-based insurance design (VBID) arrived in Washington, DC on the first day of 2017 when two of the largest federal government healthcare programs launched VBID demonstration programs.  The long-awaited Center […]

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A look back at popular blogs of 2016

Dec. 29, 2016

Happy New Year and thank you to all our readers! Before we officially start 2017, catch up on five of Inside Angle’s most read blogs of 2016: Overcoming skepticism about […]

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Observations from the corner of Medicare Advantage and MACRA

Nov. 2, 2016 / By Clark Cameron, Gretchen Mills

In early October, CMS surprised everyone and published the highly anticipated Final Rule on MACRA well ahead of schedule. A number of blogs have since provided high-level summaries of the […]