As the Medicare Advantage market continues to evolve amid regulatory change, margin pressure, and ongoing member movement, it remains a crucial growth and performance priority for many health plans.

This guidance sets out the minimum requirements to deliver quality surveillance for patients at risk of hepatocellular carcinoma (HCC). It supports hepatology, gastroenterology, and radiology services ...

Customer stories Events & webinars Ebooks & reports Business insights GitHub Skills ...

For most of Medicare Advantage's history, RADV audits were sporadic. CMS selected a handful of contracts each year. The ...

Agentic auditor that flags unsubstantiated CMS-HCC risk-adjustment codes in clinical documentation, grounded against a deterministic Rust scoring engine as a verifiable oracle. Built on synthetic d ...

Correspondence to Dr Feng Shen and Dr Jun-Hua Lu, Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No 225, Changhai Road, Yangpu District, ...

Objective Phase II trials suggest glucagon-like peptide-1 receptor (GLP1) agonists resolve metabolic dysfunction-associated steatohepatitis but do not affect fibrosis regression. We aimed to determine ...

Designing innovative cancer therapies requires extensive characterization of the genetic, biochemical and cellular alterations causing tumor development and progression. Cancer hallmarks involve ...