The way that the risk adjustment model scores for the number of chronic conditions a person has been diagnosed with would be changed for 2017 — reforms aimed at ensuring that the metrics are accurate, evidence-based, and transparent.
The re-evaluation would include a consideration of using data from two years — in this case 2013 and 2014 — to determine risk scores. Stakeholders like the Medicare Payment Advisory Commission, managed care organizations, and beneficiary groups would be consulted when creating the other elements of a new evaluation. CMS would also have to consider the socio-economic status of beneficiaries when evaluating changes in the program.
The Dept. of Health and Human Services would report to Congress every three years after 2017 and describe revisions (if any) that have been made that are related to this legislation.