Medicare AdvantageAdministrativeMedium impact
MAPAP252 - Risk Adjustment Accuracy Program - Annual update to the program criteria to include 2026 metrics
Blue Cross of Idaho·ID · Family Medicine, Internal Medicine, General Practice·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho updated their Risk Adjustment Accuracy Program for 2026, establishing new performance metrics for Medicare Advantage value-based care providers. The policy sets specific targets for Annual Wellness Visit rates (40% year-end, 15% Q2) and HCC Reconsideration rates (30% year-end, 15% Q2) with 5 performance levels.
Action Required
By October 31, 2025: Primary care providers participating in Blue Cross of Idaho Medicare Advantage value-based contracts must review new 2026 performance targets. Billing team should ensure Annual Wellness Visit encounters are properly coded with appropriate CPT/HCPCS codes and ICD-10-CM diagnosis codes. Request complete code sets from Blue Cross of Idaho and update tracking systems to monitor quarterly performance against the new 5-level rating system.