To understand what you can gain, your organization needs to know what to look for and why. The key performance measures included provide focus on what to quantify and watch closely, year-over-year, to better understand organizational strengths and weaknesses.
Effective risk adjustment under value-based care requires the right technology that works with your team, not against it. It should empower your experts to do their job at the top of their licenses and qualifications. Read up on how to evaluate current and future partners.
Accordingly, as risk adjustment becomes more necessary to support care and generate revenue, it's critical to not lose sight of your own available human expertise. Even with the best clinically focused NLP on the market, ultimately AI tools don't make decisions. Your care teams and coders do. Learn how to harness that expertise and amplify their impact.
Risk adjustment has a continuum of process maturity. It begins at zero risk adjustable lives and moves to engaging in up- or down-side models for millions of patients. Regardless of your place on the spectrum, risk capture improvements can be significant, impacting financial rewards and establishing a foundation on which to build future care initiatives.
Risk adjustment can be a moving target. Regional variations, population funding differences, even public health challenges like pandemics can disrupt goals. That’s why we unpack the metrics you need to watch, include different targets for each, and explain how they all relate to each other and the big picture.
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