Medicare Advantage News: EDS System for MA Takes Hold; Use for Risk Adjustment Is Coming

As of this past April, CMS’s new Medicare Advantage encounter-data system (EDS) had processed 132 million provider “encounters,” and 98% of MA organizations in 2012 were fully certified by the agency in use of the system, according to the CMS official who heads the program. This in turn appears to mean that CMS is getting closer to shifting its MA risk-adjustment system for determining plan payments over to use of EDS, although it is likely that even if the agency starts using EDS for risk adjustment next year, plans would have until 2016 to fix any problems found…