In the world of healthcare, accurate risk adjustment is crucial. It ensures fair reimbursement for providers by reflecting the health complexity of their patient population. But with a growing emphasis on value-based care, is a traditional Risk Adjustment Solution enough?
Is Your Risk Adjustment Solution Missing the Mark? 3 Questions to Ask Now!
Here are the three key questions to ask yourself if you suspect your current solution might be falling short:
1. Does it Capture the Full Picture of Patient Health?
HCC (Hierarchical Condition Category) coding is a cornerstone of risk adjustment. It translates diagnoses into codes that determine risk scores. However, HCC coding relies heavily on claims data, which often lacks details about a patient’s current health status.