What is Risk Adjustment in Healthcare?

Risk adjustment is a critical part of both the financial and clinical ...
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Machine Learning in Healthcare and the Value of Human Expertise

When discussing artificial intelligence like NLP, the use of machine learning in ...
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Pre-Encounter Risk Adjustment: If You Try Sometimes, You Get What You Need

As the significance of provider risk adjustment grows, especially within the clinical ...
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CMS Submission Deadline Extension Clarification

On 9/18/20, CMS announced a submission deadline extension option for 2020 dates ...
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Medicaid Risk Adjustment: Even if Your State’s Medicaid Hasn’t Expanded, Your Risk ...

Managing Medicaid risk adjustment is almost never a top priority. State by ...
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HCC Recapture is Critical, HCC Recapture is Never Enough

Recently, we discussed the imperative of HCC recapture, especially in a year ...
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CMS Policy Update on Encounter Data and Positive Risk Score Impact

On September 14th, CMS released part I of an advanced notice on ...
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HCC Recapture Rate for Disease Burden, Provider Performance, and COVID-19 Risk: How ...

An effective and essential risk adjustment strategy includes the prioritization of chronic ...
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ACO Benchmark Calculation: Successfully Understanding the two Levers of Cost and Risk

Our latest ebook, Pulling Both Levers: A Four-Year Analysis of Medicare Cost ...
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Medical Loss Ratio and COVID-19: Investment, Risk, and Looking through 2022

For payors, Medical Loss Ratio is down to a point of short-term ...
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True Disruption: Three Ways the Pandemic has Shaped Risk Adjustment Technology

Health Fidelity CEO Steve Whitehurst shares how our company has worked to ...
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Flattening the Other Curve: Using Risk Adjustment to Manage Rebounding Patient Volumes

As care patterns continue to shift, and we see new utilization patterns, ...
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