A 3% Annual RAF Improvement isn’t Nearly Enough.
Depending on the individual risk sharing arrangement, CMS will cap annual risk score improvement to a 3% RAF lift over the benchmark for a population. This can lead to a very common assumption, that 3% can be used as an obvious, un-nuanced goal for risk adjustment strategy each year. Unfortunately, this is incorrect. Fortunately, we’re […]
What is two-sided healthcare risk?
Depending on your role at a health plan or risk bearing health system, you’re aware of value-based care (VBC) models. However, depending on the model itself (and sometimes within the same model of value-based care), there can be different variations of two-sided healthcare risk, also known as upside and downside. An organization’s level of engagement […]
ACO Benchmark Calculation: Successfully Understanding the two Levers of Cost and Risk
Our latest ebook, Pulling Both Levers: A Four-Year Analysis of Medicare Cost and Risk Adjustment, unpacks the critical, and often overlooked, importance of effective risk adjustment done in conjunction with medical expense reduction under value-based care.
Tag: Accountable Care Organization / ACO
Risk adjustment plays a critical role in value-based reimbursements. It’s important for accountable care organizations (ACO) to understand how risk adjustment works and its impact on your financial performance. Learn more about ACOs in our blog.