patvann/hcc-annual-wellness-visit
Resources
Increasing Medicare Annual Wellness Visits in Accountable Care Organizations
Medicare’s annual wellness visit (AWV) was introduced in 2011 as an opportunity for providers to focus on aspects of preventive care for eligible beneficiaries. Despite potential incentives for doing so, adoption of the AWV has been slow, which may be contributing to a relative paucity of data evaluating how conducting AWVs affects patient outcomes and health care spending. In this article, we discuss how a large Medicare accountable care organization implemented several innovations aimed at decreasing barriers to scheduling and increasing the efficiency and convenience of conducting AWVs, which led to a substantial increase in AWV rates within 12 months.
View Resource PaperRisk Adjustment of Medicare Capitation Payments Using the CMS-HCC Model
This article describes the CMS hierarchical condition categories (HCC) model implemented in 2004 to adjust Medicare capitation payments to private health care plans for the health expenditure risk of their enrollees. We explain the model's principles, elements, organization, calibration, and performance. Modifications to reduce plan data reporting burden and adaptations for disabled, institutionalized, newly enrolled, and secondary-payer subpopulations are discussed.
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