risk adjustment: a roadmap to success
TRANSCRIPT
©2016 Availity, LLC | AV706-0816
RISK ADJUSTMENT: A Roadmap to Success
AVAILITY WHITE PAPER
AN AVAILITY E-BOOK
QUANTITY
Quality over Quantity: New payment models are compensating health plans and providers for the quality of care they deliver rather than individual services.
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RISK ADJUSTMENT: A ROADMAP FOR SUCCESS
AN AVAILITY E-BOOK
QUALITY
RISK ADJUSTMENT: A ROADMAP FOR SUCCESS
AN AVAILITY E-BOOK 3
This means new risk adjustment models MUST:
• Be more precise
• Include the direct costs of primary care services and the management of chronic conditions
• Include the indirect costs of care coordination.
RISK ADJUSTMENT: A ROADMAP FOR SUCCESS
AN AVAILITY E-BOOK
The need for more precise risk adjustment models means it’s more important than ever for accurate and timely data. But existing processes for managing this data don’t fit the bill.
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RISK ADJUSTMENT: A ROADMAP FOR SUCCESS
AN AVAILITY E-BOOK
Ready to learn more? Download our white paper, Risk Adjustment: A Roadmap for Success.
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RISK ADJUSTMENT: A ROADMAP FOR SUCCESS
AN AVAILITY E-BOOK
Multiple departments within a health plan collect provider data for different purposes and store it separately.
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RISK ADJUSTMENT: A ROADMAP FOR SUCCESS
AN AVAILITY E-BOOK
Organizational silos are inefficient and disruptive to providers, who must field multiple requests—via phone call, fax, and in-office visits—from health plan employees looking for access to the same patient medical records. This is the Chart Chase.
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RISK ADJUSTMENT: A ROADMAP FOR SUCCESS
AN AVAILITY E-BOOK
Because providers are a critical source of patient information, health plans must have a way to capture data in a less intrusive way, or the quality of data will continue to suffer.
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RISK ADJUSTMENT: A ROADMAP FOR SUCCESS
AN AVAILITY E-BOOK
Health plans need a digital, scalable, enterprise-wide solution that:
• Works seamlessly over existing systems;
• Ensures data accuracy and eliminates inefficiencies; and
• Is able to pull components for HEDIS, STARS, and Care Management alongside risk adjustment and bundle them together.
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DIGITAL
SCALABLE
ENTERPRISE
RISK ADJUSTMENT: A ROADMAP FOR SUCCESS
AN AVAILITY E-BOOK
Read more in depth about what the future holds for risk adjustment. Download our free whitepaper, Risk Adjustment: A Roadmap for Success.
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