Risk Adjustment

CMS Final Call Letter 2019

Calendar Year (CY) 2019 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter


The 2019 CMS announcement contains the following attachments:


  • The final estimates of the National Per Capita MA Growth Percentage for 2019 and the National Medicare Fee-for-Service (FFS) Growth Percentage for 2019. These growth rates were used to calculate the 2019 capitation rates.
  • Details of the key assumptions and financial information behind the growth percentages presented in Attachment I.
  • Responses to Part C payment related comments on both Parts I and II of the Advance Notice of Methodological Changes for CY 2019 MA Capitation Rates and Part C and Part D Payment Policies (Advance Notice).
  • Responses to Part D payment related comments on the Advance Notice.
  • Final Part D benefit parameters and contains details on how they are updated.
  • CMS-HCC and CMS-HCC ESRD Risk Adjustment Factors
  • Final Call Letter

Download the full document HERE



We simplify the management of member programs by making it radically more efficient, and increasing value to healthcare organizations and their members

Presentation @ RISE VBC: Effective Collaboration Strategies Between Payer & Provider