Prioritizing Risk Capture Compliance with NLP
In the past few weeks, several new stories have broken around risk capture compliance issues, particularly when it comes to Medicare Advantage. Individual DOJ lawsuits around MA risk capture and government agencies like the OIG weighing in on MA policy itself have led to a barnstorm of op-eds. The crux of these stories, even the […]
What is HCC Coding in Risk Adjustment?
Despite the pivotal role value-based care has in healthcare in the United States, it’s often not well understood. In the same spirit in which we covered the basics of risk adjustment and two-sided risk, today we want to tackle HCC coding in risk adjustment. With any luck, you’ll come away with a better understanding of […]
HCC Recapture is Critical, HCC Recapture is Never Enough
Recently, we discussed the imperative of HCC recapture, especially in a year with encounter volumes heavily disrupted by COVID-19. However, HCC recapture is only a small part of the larger goal: discerning a complete and accurate risk profile of a covered population. With an accurate risk score, reimbursement can match the total cost of necessary […]
Value-based Care is Here to Stay: The Path to Accurate and Complete Risk Capture
As providers take on increasing levels of risk, they need to understand the maturity of their processes, the workflows they need to optimize, and the levers they can pull to improve their risk adjustment outcomes. Find out how our risk capture maturity model can help you plan your improvement path forward.
Value-Based Care is Here to Stay: Key Strategies for Developing a Risk Adjustment Program
Our comprehensive, encounter-centric framework helps providers develop an effective risk capture program to achieve success in value-based care.