Targeting risk adjustment opportunities intelligently for the greatest financial impact.
Many risk adjustment vendors use analytics simply to drive volume; ArroHealth uses analytics to drive performance. 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 medical record retrieval strategy begins the analytics of AggregationIQ®.
AggregationIQ leverages ArroHealth’s analytics and our superior provider relationships and insight throughout the U.S. Our proprietary provider selection algorithm identifies providers with a high number of successful retrievals and a comprehensive coding and documentation history to reduce provider abrasion and costs for clients. Our robust provider engine offers insight into the best methods of collection, the most cooperative providers and those with minimal copy service fees, which creates the smartest way to launch the retrieval process. This intelligence achieves the most efficient retrieval results and premium impact for health plans and provider groups.
Effective risk adjustment analytics go deeper than primary claims data.
We go beyond what is captured in primary claims systems. We combine and account for every data feed that health plans receive today: standard encounters, filled prescriptions, HL7 EMR protocols, HEDIS results and enrollment in disease management programs. This depth of analysis enables us to target your risk adjustment opportunities with maximum accuracy.
Our algorithms incorporate the latest industry standards.
Clinicians and statisticians developed our prospective and retrospective algorithms, combining advanced medical knowledge and evidence-based guidelines with statistically valid rule sets. Our reference tables include all the latest ICD-9 and 10, CPT, HCPS, LOINC, NDC and HL7 codes. And we receive frequent updates to these and other healthcare datasets, so our algorithms consistently use the newest code sets, measures and standards in the industry.
We run risk adjustment analytics year-round.
Setting us apart from other solutions, we consistently run risk adjustment analytics year-round in accordance with the CMS calendar and other state-based provisions. We work with you to track results, model impact and verify accurate follow-through with regulatory agencies. This ensures maximum improvement in financial, clinical and quality outcomes for our clients.
Request a demo today to learn more about how our analytics process can help improve your ROI.