Thomas E. Hutchinson, a Strategic Advisor for EBG Advisors Inc., was quoted in AIS Health Business Daily, in “Duals Plans Praise CMS’s Risk-Adjustment Changes Memo, Seek Coefficient Details.” The article originally appeared in Medicare Advantage News and was reprinted with permission.
Following is an excerpt:
Another potential concern, according to Hutchinson, is that the new model could take money out of certain MA plans since the system is based on FFS data. He suggests this could occur, for instance, in an urban area (i.e., where there usually is a higher percentage of duals than in rural areas) because the overall risk score for the area must be 1.0. Since MA plans with a lot of full duals would get more money under the new model, other MA plans with few full duals “possibly could get less.”
Reservations notwithstanding, however, Hutchinson is quick to add, the overall change CMS is contemplating can’t be argued with since it would be more accurate than the current model.