MAPD: Risk Adjustment and Data Validation

<p>This course identifies the principles and motivation for risk adjustment of capitation payments that the Centers for Medicare &amp; Medicaid Services (CMS) makes to Medicare Advantage (MA) plans. Topics in this course include: History, Goals, Hierarchical Condition Category (HCC), Documentation and Coding Requirements, Data Flow, and Data Validation. After completing this course, learners will be able to identify the components of the risk adjustment process, the requirements for data collection, and the process for submitting data to CMS. </p>

After this course learners will be able to identify the principles and motivation for risk adjustment. identify the components of the risk adjustment process. recognize the requirements for data collection and the risk adjustment data flow. recognize the importance of risk adjustment data validation (radv).