An Emerging Management Trend for Medicare Advantage Plans [MAPs]
By Dr. David Edward Marcinko; MBA, CMP™
So called Hierarchical Condition Category Management (HCCM) is an emerging healthcare management trend designed to accurately reflect the health status of Medicare Advantage Plan [MAP] members and to help them remain financially viable in Part D of the system.
Since the Medicare risk adjustment payment system uses clinical coding information to calculate risk premiums for Medicare Managed Care Organizations (MMCOs), HCCM seems best to address the following:
- CMS risk adjustment system.
- Strategic and financial implications for Medicare plans.
Any initiatives required to effectively managed care under a risk adjustment payment system is ripe for HCCM and the key success factors associated with these initiatives.
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Filed under: "Doctors Only", Drugs and Pharma, Managed Care, Practice Management | Tagged: HCCM, Hierarchical Condition Category Management, MAPs, Medicare Advantage Plans, Medicare HMOs, Medicare Part D |