Medicare Advantage: Changes Improved Accuracy of Risk Adjustment for Certain Beneficiaries: GAO-12-52 (Paperback) (ISBN-13: 9781287207184)

The effect of CMS's revised community model on payment accuracy varied for the high-risk groups studied. Specifically, compared with the current community model, the revised community model slightly reduced the accuracy of MA payment adjustments for beneficiaries with multiple chronic conditions by $164, or about 1 percent of average actual expenditures. For beneficiaries with low income, the accuracy of the revised and the current community models was similar: estimates differed by $5, or less than 0.1 percent of average actual expenditures. For beneficiaries with dementia, the revised community model substantially improved the accuracy of MA payment adjustments by $2,674, or about 16 percent of average actual expenditures.

Author: U. S. Government Accountability Office (
ISBN-10: 1287207189
ISBN-13: 9781287207184
Publisher: Bibliogov
Language: English
Published: 05/16/2013
Pages: 42
Format: Paperback
Weight: 0.21lbs
Size: 9.69h x 7.44w x 0.09d