Risk Adjustment Optimization
For Improved Results

Risk Adjustment Factor (RAF) Optimization

  • 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).

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Moving from Fee-for-Service to Fee-for-Value An Integrated Approach to Decreasing Cost and Improving Quality of Care

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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

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