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The Department of Health and Human Services (HHS) regularly refines its policies and operational guidelines in an ongoing effort to better serve patients and support sustainable value-based care delivery. To that end, HHS and CMS recently announced three important updates:
Revisions to HHS risk adjustment model algorithm software
Changes to cost-sharing reductions (CSRs)
Deployment of EDGE 38.0
These refinements are intended to improve access to affordable care and enhance the efficiency and accuracy of risk adjustment & risk adjustment reporting in ACA programs. In this article, we’ll take a closer look at the most relevant pieces of these three major updates.