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Tag: Alternative Payment Models / APMs

Alternative Payment Models (APM) reimbursements are tied to benchmarks that are risk adjusted. Successful risk capture is critical to ensuring proper reimbursements, effectively managing costs of your high-risk members, and delivering high quality care.

Risk adjustment makes sure that differences in underlying risk of patient populations are documented accurately. Read more aboutĀ Alternative Payment Models (APM) in our blog.

  • September 1, 2020

    ACO Benchmark Calculation: Successfully Understanding the two Levers of Cost and Risk

    By Adam Gronsky

    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.

    Read More ...

  • November 15, 2017

    Value-Based Care is Here to Stay: The Importance of Risk Adjustment To Provider Performance

    By Adam Gronsky

    The shift from fee-for-service to value-based care is changing not only how patients are cared for, but also how providers are measured and compensated for performance.

    Read More ...

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Health Fidelity simplifies risk adjustment, offering risk-bearing organizations clear visibility into and control over the process. Through our NLP-powered solutions and expert advisory services, we uncover insights that enable better care plans and more complete revenue capture. The LumanentĀ® suite gives our partners the confidence to pursue and ability to succeed in risk-sharing arrangements across MA, ACA, Medicaid, and ACO programs.

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