Health Care Industry Leaders Urge CMS to Include Audio-Only Encounters in Risk-Adjustment

ACHP and other health care industry leaders such as AHIP, AMGA and the Blue Cross Blue Shield Association urge CMS to allow audio-only encounters to be included in Medicare Advantage risk-adjustment. Allowing MA plans to submit diagnoses from all telehealth services for risk-adjustment is imperative to ensure that health costs are adequately captured, premiums are stable and robust benefits are preserved. Including all encounters in risk-adjustment also provides clinical care teams the information necessary to comprehensively manage their patients’ care. Without the complete and accurate documentation of diagnoses, MA plans are experiencing reductions in payments, leaving health plans and providers with fewer resources and potentially exposing patients to reduced benefits, higher premiums, and increased out-of-pocket costs in the future.

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Press Contact

All media inquiries should be directed to:

Mat Gulick
Director, Communications
Making Health Care Better

ACHP is the voice of a unique approach in health care today, one that puts the patient at the center with plans and clinical teams collaborating to improve health outcomes and reduce costs. Our advocacy focuses on providing policymakers with tested solutions, rooted in a model that is proven to deliver better value for patients, employers and taxpayers.

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