From yesterday’s CMS April 5, 2011 Announcement, pg. 2:

“Part C Risk Adjustment Model. Based on our interpretation of Congressional intent regarding changes in Part C payment methodology, CMS will not implement the new CMS-HCC and CMS-HCC ESRD dialysis risk adjustment models or the recalibrated frailty factors in 2011. CMS will implement these new models in 2012. To reference the factors in the CMS-HCC risk adjustment model that will be used in 2011, see the 2009 Rate Announcement (published in April 2008). To reference the factors in the CMS-HCC ESRD risk adjustment model that will be used in 2011, see the 2008 Rate Announcement (published in April 2007).”

Link to 2011 Announcement:

http://www.cms.gov/MedicareAdvtgSpecRateStats/AD/list.asp#TopOfPage

5 Comments

• 

  By kives72, April 6, 2010 @ 10:49 AM

  Where can I find the entire article on the CMS website?
• 

  By J. Matt Yuill, M.D., CPC, April 6, 2010 @ 10:50 AM

  2011 Announcement

  http://www.cms.gov/MedicareAdvtgSpecRateStats/AD/list.asp#TopOfPage
• 

  By kives72, April 6, 2010 @ 11:17 AM

  Thank you Matt:).
• 

  By dculling, July 19, 2010 @ 2:46 PM

  Matt,

  Matt,
  Is your interpretation of this postponement that the changes to the HCC categories and codes (eg Dementia, Metabolic Syndrome, Diabetic Complications etc) will not be added until 2012? Therefore, these new codes and changes will not be risk adjusted in 2011? If true, this would imply that focusing on and coding these codes would have no risk adjument value in 2011 for payment(interim) in 2012?

  Thanks,

  Doug
• 

  By J. Matt Yuill, M.D., CPC, July 19, 2010 @ 11:24 PM

  So, I do think these “new codes” will have to be present during Dates of Service 2011, so that they will affect Payment Year 2012.

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