Position your organization for success under CMS-HCC V28

The transition from CMS-HCC V24 to V28 heralds a significant shift in risk adjustment methodologies and emphasizes improved accuracy and granularity, promising more equitable resource distribution and significant financial implications for Medicare Advantage plans, ACOs, and other healthcare entities.

If you have not started moving toward this new model, there is no time to waste. Organizations who want to be positioned for success must proactively take steps to understand and adapt to the implications of the move to CMS-HCC V28. Our latest ebook explains how this new version of the risk adjustment model impacts organizations financially and strategically—and details clear steps that provider organizations can take to navigate this transition effectively. Here’s a quick preview:

Impact of the transition from V24 to V28

For Medicare Advantage members, this change should result in more precise risk scores and align payment rates more closely with actual health status. For ACO members, this new approach should create a stable and predictable framework for risk adjustment in benchmark and performance years. For vulnerable populations, V28 should ensure a fairer distribution of resources and more appropriate care. For providers generally, this transition should shift reimbursement rates to be more congruent with population risk.

Read the ebook for a full breakdown of the differences between V24 and V28—and the effects of these differences on various populations.

How to navigate the transition from V24 to V28

• Rapid data audit: Review your current data collection and management processes to flag improvement areas.
• Population impact analysis: Understand exactly how V28 may influence your specific patient cohorts.
• Comprehensive training: Educate staff on the impact of V28 and double down on the importance of consistent, accurate coding throughout the transition.
• Analytics surveillance: Keep close tabs on performance trends under V28 to quickly address emerging issues.
• Updated care management: Expand program offerings to include new, higher risk diagnoses and improve patient outcomes.

The ebook, The transition from CMS-HCC V24 to V28: Impacts and strategic steps, empowers provider leaders with the insight and direction necessary to succeed in this new risk adjustment landscape. Download it now.

For more tailored guidance, you can also schedule a collaborative consultation with our experts.