Think a +3% Benchmark is Enough? It’s Not.

Medicare ACOs need to set their sights higher than 3% to obtain complete and accurate risk adjustment.


Even among healthcare organizations that consider themselves experienced at addressing risk, many focus on reaching the 3% improvement cap over the prior year’s benchmark as an annual goal. While this is an excellent first step, risk-based payment calculations include multiple variables, including economic inflation and an ever-variable coding intensity factor that means a 3% YOY target is much, much too low.

And if your target is too low, the downstream consequences of an incomplete and inaccurate risk profile are significant:
  • chronic conditions are being left un-or-under documented, hamstringing physicians from creating effective care plans inclusive of all comorbidities
  • potentially millions of dollars of care funding go unclaimed, creating an increase in expenses
Our latest ebook, Staying Ahead of the Curve: National Risk Trends and Their Impact on Care Funding, builds on part 1 (Pulling Both Levers), deepening the case for a systematic, year-round approach to risk adjustment. By exploring the broader calculations that need to be understood for effective annual planning, your organization will be poised to grow and thrive under value-based care.




Download eBook Part 2

Staying Ahead of the Curve: 

National Risk Trends and Their Impact on Care Funding

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