"If organizations are
getting a 6% to 8% hit on their scores because they can't get their encounter
data stuff right, that's getting to the point of not being able to survive in
this market….I would expect that we're going to see continued big pushes from many
organizations to get on top of this."
— Eric Goetsch, a principal and consulting actuary at Milliman
Inc., spoke with AIS's RADAR
on Medicare Advantage about why some insurers are seeing much lower
encounter data system-based scores than Risk Adjustment Processing System, and
what the market impact might be.
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