By RaeAnn Grossman
Since 2005, we have used pharmacy information for suspect analytics, but now CMS is recognizing this information as truly aligned for some conditions. Starting in 2018, prescription data could be used to highlight the predictive ability of select conditions. In October 2016 the Alliance of Community Health Plans wrote a letter to Andy Slavitt stating they agreed with the inclusion of 13 drug classes to impute additional diagnoses or severity, but requested careful monitoring.
To read the 2018 CMS proposed rule visit http://tinyurl.com/zjgoq4x.
At ArroHealth, we understand that this means our clients need better data management. We can provide earlier insight into risk adjustment impact and clinical conditions.
ArroHealth will be taking a deeper look at pharmacy and risk adjustment alignment in coming blogs.
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