• Overlooking missed diagnoses is just half of the challenge of attaining accurate risk scores. Learn how solve the other half by applying technology to help with compliance in this post from Health Fidelity Director of Coding & Quality, Kathy Ormsby.

  • With risk adjustment becoming increasingly important to the bottom line of health plans and the wellness of patients, Christina Sung offers strategies for organizations to adopt new coder technology with low time-to-value barriers.

  • Risk Adjustment and Quality typically operate in distinct silos, despite the fact that they are both working to achieve goals that are closely related. Our CEO calls for collaboration between these different but closely aligned components.

  • Health plans face multiple issues that can lead to an inaccurate portrayal of patient acuity and unidentified risk. With an eye toward incremental progress, here are a few strategies for risk identification improvement.

  • One-size doesn't fit all when it comes to the underlying risk adjustment strategies health plans should pursue given the market(s) that they participate in.

  • With the right technology, the analytical value and insights gained from incorporating clinical data into risk adjustment operations is worth the effort.

  • Most organizations view risk adjustment as a necessity, but not a strategic asset. With the right measures, risk adjustment can be leveraged as a competitive advantage.

  • Greater emphasis on risk adjustment is needed in the ACA market to support plan viability, accurately establish premium prices, and withstand competitive pressures.

  • With the industry shifting toward value-based care models, there is an increasing need for health plans to continually improve their risk adjustment programs.