Which is Better for Your Practice: RAPS or EDPS?
When it comes to Medicare risk adjustment, there are two main methodologies that healthcare providers can choose from: RAPS and EDPS . Understanding the differences between the two can help you decide which is better for your practice. RAPS (Risk Adjustment Processing System) is the traditional method of risk adjustment used by CMS (Centers for Medicare and Medicaid Services). With RAPS, healthcare providers submit diagnosis codes to CMS for their Medicare Advantage patients. CMS then uses these codes to calculate risk scores, which are used to determine the amount of reimbursement the healthcare provider will receive. EDPS (Encounter Data Processing System) is a newer method of risk adjustment that was introduced by CMS in 2016. With EDPS, healthcare providers submit encounter data to CMS that includes diagnosis codes, service dates, and other information. CMS then uses this data to calculate risk scores. So which method is better for your practice? It depends on your specific s...