Implementation of Risk Adjustment for Medicare


Each resulting county rate is the Medicare per capita payment as it would be for the national average Medicare beneficiary, given the county's price and utilization patterns. The set of rates is referred to as the ratebook. HMOs were paid each enrollee's county rate adjusted for the individual's factors, based on age, sex, Medicaid status, etc., the bigbayhouse.infoon: Rockville Pike, Bethesda, MD.

This rate was equal to 95 percent of the projected per capita FFS costs in the county, divided by the average demographic factor for the county FFS population.

Working Papers & Publications

Good news for Medicare Advantage plans! The early preview of growth rates released by CMS on November 27th includes growth rates that are double those of the last three early previews. Table 1 of “Early Preview – CY Medicare Advantage Ratebook Growth Rates” .

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