5 Ways Payers Can Ensure Risk Adjustment Compliance
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…
Risk Adjustment and the Renewed Importance of HCC Coding
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…
Leveraging Technology to Overcome Risk Adjustment Barriers
The pandemic-era risk-adjustment challenges facing healthcare payers and risk-bearing providers are numerous, and they are not limited to the persisting economic impacts of COVID-19. Technology is vital to overcoming current…
Preparing Risk Adjustment Solutions for a Post-Crisis World
Risk adjustment has always been a challenging endeavor, but one essential to fairly compensate payers for taking on patients who are more likely to have high healthcare costs. Government programs,…
How Value-Based Care Has Changed Revenue Cycle Management
As the transition from fee-for-service to fee-for-value gains momentum, its impacts on revenue cycle management are seen with greater clarity. Value-based care wields significant potential advantages for patients, providers and…