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Have we reached parity between Medicare Advantage RAPS and EDS risk scores?

ByDavid Koenig, Emily Vandermause, and Rebecca Gergen
31 July 2020

Starting in 2016, the Centers for Medicare and Medicaid Services began phasing out the use of the Risk Adjustment Payment System data that historically has been the sole source for calculating Medicare Advantage risk scores, with the goal of ultimately replacing it with the Encounter Data Processing System (EDS). With 2022 just around the corner, it is important that Medicare Advantage organizations understand the expected impact of EDS as the single source of diagnoses for calculating risk scores and the impact this transition may have on their revenue.


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