RISE to Publish RAPS to EDPS Findings: Get the Scoop!

Those of us who participated in the call with CMS on Thursday morning heard that there are problems rolling out this transition from RAPS to EDPS and that CMS is closely focused on the issue.  However, the healthplans included in the RISE RAPS to EDPS transition data collaboration are already way ahead on this topic. I am very pleased to announce that RISE will be publishing the results of our study shortly, which will benefit all plans involved in the RISE community. 

Nearly a year ago, RISE initiated a collaboration with our technical partners at Inovalon.  Through the sponsorship from Jason Rose, Chief Strategic Development Officer at Inovalon, the support of their executive leadership and the hard work of the Inovalon team, data from a group of healthplans has been gathered and processed on their RAPS and EDPS data in a large scale benchmarking study. The pool of Medicare Advantage membership exceeds 1 ½ million lives, providing us with the range and scope to draw some important conclusions about how the transition will affect the RAF scores, and hence, the revenues of Medicare Advantage plans across the country as the program is phased-in this year and the years to follow. 

At this moment, preliminary findings are emerging that demonstrate a lot of variability and some concerning trends which are being further analyzed.  We will be publishing the final results next month for the RISE members to see.  In addition, we were recently informed that the major trade association for our industry requested a 75 minute panel discussion about the study at their conference in Las Vegas in mid-June, which coincides with our target date for publication of results.  Representatives of the RISE RAPS to EDPS steering committee will be involved in the panel, so if you are able to attend, you will hear first-hand about the findings.  Once we have the analysis prepared next month, we will be publishing it on the RISE website.  So stay tuned! 

Kevin Mowll, Executive Director

RISE


Categories: risk adjustment, CMS
Tags: RAPS, EDPS, CMS, study, data collaboration, RAF scores, Medicare Advantage payment

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