Posts Tagged ‘CMS’
Navigating the Mandatory Transition to CMS-HCC Model V28
The V24 to V28 shift began in 2023. While not new for many risk groups, the completed 2026 rollout will likely lower risk adjusted payments.
Read MoreSurviving V28: What to Do When Members’ Medical Expenses Exceed the Capitated Payments of CMS Models
Revenue misalignment creates risk. FRG’s Revenue and Audit Monitoring Program (RAMP) helps manage it under global capitation.
Read MoreValue-Based Contracting: Different Perspectives, Common Threads
HFM’s October and November magazines featured Value-Based Healthcare articles. The experts had different perspectives, and we see common threads.
Read MoreTransparency, c/o Pennsylvania Avenue
CMS is taking action to bring claims data to the point of care. We’re all for it!
Read MoreCost and Compensation: A Values Based Approach
Creating a collaborative and results focused economic environment requires a values based approach to cost and compensation for physicians and payers.
Read MoreHospital Readmission Reduction Program Audit
Understand the ins and outs of a hospital readmission reduction program audit and the complexities around DRG readmission policies from the FRG experts.
Read MoreMedical Risk Adjustment in Global Capitation Arrangements
Gain the framework needed for understanding medical risk adjustment and the business processes required to perform under a global capitation arrangement.
Read MoreReinsurance and Stop Loss in Provider Incentive Plans
Get the facts about reinsurance and stop loss in provider incentive plans. Review the types of agreements and benefits of stop loss programs.
Read MoreMedicare Risk Adjustment (MRA) Key Dates and Best Practices
Get the facts about Medicare Risk Adjustment (MRA) and the best practices around implementation. Don’t let MRA scare you off, get it right with our help.
Read MoreCMS Provider Incentive Plans (PIP) Regulations and Stop Loss Reinsurance Requirements
An in depth review of the CMS Provider Incentive Plans (PIP) regulations and the Stop Loss Reinsurance requirements from the FRG expert editorial team.
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