Webinars

Thursday, April 30, 2026, 2:00 pm ET

Darryl Drevna, MA, Senior Director, Regulatory Affairs, AMGA

In this webinar, you will learn about: 

• Final MA Payment Update and Rate Impact: Analysis of the finalized CY 2027 capitation rates, how they compare to the proposed 0.09% update, and what they mean for care delivery budgets, network sustainability, and supplemental benefit offerings

• Risk Adjustment Methodology Changes: What CMS finalized regarding the risk adjustment model, including any changes to the risk score trend calculation, the ongoing transition to the V28 HCC model, and implications for provider reimbursement and care management resource planning

• Audio-Only Telehealth and Risk Adjustment: Final policy on whether diagnoses from audio-only encounters will count toward risk adjustment, and what this means for members serving rural, elderly, and socially vulnerable populations

• Chart Review Records (CRRs) and Unlinked Diagnoses: CMS' final approach to the use of unlinked chart review records in risk adjustment, including any documentation standards or phase-in provisions, and how this affects chronic disease management documentation practices

• Provider-Payer Incentive Alignment and Acuity-Adjusted Payments: Updates on CMS' direction regarding pass-through of risk-adjusted payments to providers and any new requirements for MA organizations

• Star Ratings and Quality Bonus Payment Updates: Finalized changes to quality measurement, including any new outcome-based measures related to prior authorization timeliness, care transitions, and functional decline prevention

• Medical Loss Ratio and Payment Transparency: Final policies on MLR calculation, spending category definitions, and any movement on separating Part D costs into a distinct risk pool

• Nutrition, Well-Being, and Supplemental Benefits: What CMS finalized regarding plan flexibility for cost-sharing waivers on nutrition and wellness services, and implications for care delivery

• Operational Takeaways for AMGA Members: Practical guidance on preparing for CY 2027, including coding and documentation adjustments, contract negotiation considerations, and care model planning in light of the finalized policies

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