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CMS regulations call for a prospective risk adjustment solution with PCP involvement
CMS continues to intensify oversight of Medicare Advantage (MA) risk adjustment practices with the 2027 Final Notice, significantly curtailing the use of retrospective risk adjustment diagnoses that are not supported by a qualifying patient encounter. This latest policy direction reflects a broader multi-year regulatory trend aimed at strengthening program integrity, tightening documentation standards, and reinforcing encounter-based risk adjustment accuracy.
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Relieve the burden of coding and documentation
Provider members of the Kentucky Primary Care Clinically Integrated Network found support in the Vatica program at no cost. Vatica relieved the burden of coding and documentation while generating additional health plan compensation. Read our case study for the noteworthy results.
Relieve the burden of coding and documentation with Vatica
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