A successful risk adjustment program means focusing on the best opportunities for revenue improvement. Our analytics system identifies:
The most important members to target for premium accuracy
The most effective outreach method
Opportunities for care gap closure
The most cooperative providers
ArroImpact, our risk adjustment analytic engine and ArroInsight, our quality engine apply thousands of clinically-driven algorithms to compile a complete risk adjustment data set, and identify actionable gaps in care, documentation, quality, and assessment to improve risk score accuracy.
Intelligently targeting risk adjustment opportunities to yield greatest financial impact.
Many risk adjustment vendors use analytics simply to drive volume; ArroHealth uses analytics to drive performance and impact. Our proprietary algorithms go beyond typical suspect identification. They evaluate all current members’ disease states, historical trends and behavior patterns to zero in on those who represent the highest potential for financial and clinical return.
We turn insight into the right action.
Our analytics system stratifies your population according to who has the highest probability of incomplete, missing or inaccurate codes. We then deliver a strategic intervention plan. Our algorithms determine the best outreach method for each member through medical record retrieval and review. We also calculate the likelihood of success for each member and demonstrate the potential financial impact and ROI.
An intelligent data aggregation strategy begins with the analytics of AggregationIQ.
AggregationIQ leverages ArroHealth’s analytics and our superior provider insight applications and provider relationships, which span across the U.S. Our proprietary provider selection algorithms identify providers with a high number of successful patient interventions along with a comprehensive coding and documentation history to reduce provider abrasion and costs for clients. Our extensive provider engine offers insight into the best methods of capturing risk adjustment and quality data for both prospective and retrospective activities. The engine identifies the most cooperative providers and those with minimal add-on fees, which creates the smartest way to launch any risk adjustment initiative. This intelligence achieves the most efficient chart retrieval results and prospective assessments for impact to health plans and provider groups.
By RaeAnn Grossman What does your risk adjustment team need to think about from application time to bid season? Answers include but are not limited to: Are we changing our formulary and will this impact Rx risk adjustment? Are we narrowing our provider networks and will this impact campaigns or waves? Are we capitating more […]
By RaeAnn Grossman First, have you integrated compliance and risk adjustment? Have you embedded your risk mitigation strategies? Here are a few items that should be on your compliance for risk adjustment checklist: Review coding guidelines quarterly (internally and with vendors) Perform 2LR and 3LR annually Embed claims validation into Medicare Advantage, Commercial, and Medicaid […]