- Chart Reviews done for coding education and documentation Improvement.
- Gap Analysis (documentation vs coding).
- Remedial Help (Coder/Physician Education including Template modification).
- Average RAF scores improved from 0.5 to 1 - 1.25 (Medicaid).
Sustainable Practices for Capturing Risk Adjustment Bonus Payments
The manual processes being used by health plans and provider groups lack sustainability, in an environment realizing a rapid expansion of value-based care payment models.
Scale and Stability In Risk Adjustment
Teamwork in a Risk Adjustment Program. The Process within the Process. In the best and most stable of times, change in any kind of business strategy can be risky.
Moving from Fee-for-Service to Fee-for-Value An Integrated Approach to Decreasing Cost and Improving Quality of Care
The U.S. spends over $8,250 per capita on health care every year. That's 22% higher than the next highest country and 170% higher than the average of the 50 highest-spending countries in the world! Read more
HEDIS and Risk Adjustment Reviews Combined The Impossible Dream?
Although health plans annually perform both Risk Adjustment reviews and HEDIS quality abstractions, there is significant duplication of efforts when obtaining the charts needed for both programs because there is often little communication between them. Read more