Risk Model Changes Would Result in Major Cuts to MA

As part of the 2024 Medicare Advantage and Part D Advance Notice, CMS is proposing a new risk adjustment model for 2024 with major revisions:

1. Model Data Years: CMS would update the data years used to calculate the model’s risk factors,
2. Model Use of ICD Diagnoses Codes: CMS would move from using ICD-9 diagnosis codes to using ICD-10 diagnosis codes in creating the model, and
3. Changes to Diagnoses & Condition Categories: CMS would make numerous changes to the diagnoses and condition categories (HCCs) included in the model.