Episource Bulletin
The transition from RAPS to the EDS for calculating Medicare Advantage risk scores, payer organizations should have a plan to minimize system errors.
The shift from RAPS to EDS for Medicare Advantage is a massive undertaking. CMS released Parts 1 & 2 early to give plans plenty of time to prepare.
For CY 2022, CMS has proposed that encounter data submissions would be the only source used in risk score calculations. RAPS would no longer be used.
The Encounter Data System (EDS) and Risk Adjustment Suite of Systems (RASS, which is more commonly referred to with the catch-all RAPS).
Benchmarking is the primary means through which CMS holds ACOs accountable and evaluates how effective they have been in lowering expenditures.
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