Success Code Update

Of all the changes announced by CMS in its final call letter, one proposed risk-coding change didn’t make the cut.

It looks like the risk-adjustment for total disease burden is going to be put off until at least 2020 to create more time for study. You can read more about that proposed adjustment here.

Although it’s a “final” decision by CMS, the total disease burden adjustment is actually mandated by law in the 21st Century Cures Act. If some legislators get a bee in their bonnet about the delay, it may be implemented outside the normal decision cycle.

At worse, it means you won’t get quite the payoff for comprehensive patient coding, at least not until 2020.

That doesn’t mean you shouldn’t do it, it just means now you need to do it exceptionally well.