On May 14, 2024, the Centers for Medicare & Medicaid Services (CMS) published the 2022 Benefit Year HHS-RADV Results Memo, including Appendix A. This critical document provides an in-depth analysis of error rates, adjustments to risk adjustment state transfers, and other significant implications from the 2022 CMS RADV results. For health plan administrators and professionals involved in risk adjustment, understanding these findings is crucial. They are essential for refining strategies and ensuring compliance.

What’s Included in the 2022 CMS RADV Memo?

The 2022 CMS RADV Memo offers comprehensive insights that can impact your approach to risk adjustment. It outlines key areas that need attention, such as error rates affecting state transfer adjustments. These findings are important. They could influence how health plans approach their risk adjustment strategies in the coming years.

Why These Findings Matter

For health plans, accurately capturing and coding high-risk conditions is crucial for proper risk adjustment. It ensures that resources are allocated efficiently. The 2022 RADV results highlight areas where errors are most common. Understanding these pitfalls can help health plans improve coding accuracy, reduce audit risks, and enhance overall performance.

Access our infographic to learn the following:

To help you navigate the complexities of the 2022 CMS RADV results, we’ve created a comprehensive infographic that breaks down the key findings and their implications. This visual guide covers:

• 10 Key Findings from the CMS RADV Memo: Get a concise overview of the most critical points that could impact your risk adjustment strategies.
• Audit of Top 5 High-Risk HCCs and Their Failure Rates: Understand which high-risk Hierarchical Condition Categories (HCCs) have the highest error rates and why they’re so challenging.
• Common Coding Errors for These 5 High-Risk Conditions: Learn about the most frequent coding mistakes made for these conditions and how to avoid them in future audits.

Don’t forget to read about the 7 Key Conditions That Can Cause Diagnosis Codes to Fail a Risk Adjustment Audit.