Medicare Advantage (MA) risk adjustment (RA) relies on strong connections between members, providers, and payers, accurate coding, and detailed data submissions. It is a process that continues to evolve to…
As Medicare Advantage (MA) plan options have expanded, the number of insurers wading into MA’s often murky waters is likewise growing. This shift to value-based care from fee-for-service care that…
The financial health of many risk-bearing providers hinges on compliance with risk adjustment and hierarchical condition category (HCC) coding directives associated with Medicare Advantage plans and certain Medicaid plans. Yet…
Reducing costs is a priority for most healthcare providers. Still, efforts to curtail expenses have been disrupted by the pandemic's persistence, the ongoing labor shortage, supply chain delays, and changing…
Amid evolving patient access preferences, the ongoing healthcare workforce shortage, and the drive for compliance with electronic medical record (EMR) and interoperability standards, an optimal pairing of technology and human…
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