Health plans operating in healthcare’s changing landscape encounter many unknowns. With the passage of the Affordable Care Act, health plans who can collect the most accurate data on their member populations will improve their opportunities for financial, quality, and clinical improvements. Accurate coding and efficient medical record retrieval services are an effective way to manage the care, medical costs, and financial impact of risk-adjustable members.
By RaeAnn Grossman Ok, we all know that our EMR systems lack interoperability and that this is a barrier to efficiency and knowledge. We have a choice, a legislative answer or innovative an answer. We either need legislation to enforce interoperability standards or to create an innovative solution to overlay or embed into EMRs to […]
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 […]