Risk coding adjustment

On January 31, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2025 Advance Notice for the Medicare Advantage (MA) and Medicare Part D Prescription Drug Programs that would update payment policies for these programs. The Advance Notice proposes annual updates to MA payment growth rates and changes to the MA and Part D payment methodologies to improve payment accuracy. For calendar year 2025, CMS proposes an MA payment increase of 3.7 percent, or over $16 billion; however, the agency also proposes a 3.9% risk coding adjustment. The CY 2025 Advance Notice also includes the continued phase-in of the updated MA risk adjustment model and updates to the calculation of growth rates related to medical education...