We manage over 5,000,000 members within our Medicare Advantage risk adjustment solutions. Each population (or line of business) has distinct healthcare demands, clinical clues, compliance concerns, and best practices for success in risk adjustment. The Medicare Advantage population is the most studied (from a risk adjustment standpoint).
ArroHealth offers the following services around Medicare Advantage members and patients:
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 […]