Blog

With increased audits and crackdowns on inaccurate risk scores, it’s more important than ever to have a comprehensive coding review process in place.

To navigate the transition to value-based care, healthcare organizations need to integrate both prospective and retrospective strategies into their risk-adjustment programs.

The impact of the pandemic and the evolution of value-based care increase the urgency in needing to understand your risk adjustment program performance.

Combine analytics and expertise to find and prioritize interventions that impact financial and clinical outcomes.

Learn everything you need to know about how DCE beneficiary alignment impacts risk adjustment.

As a thought experiment, let's track a hypothetical EDI file through submission to CMS. As of this writing, there are still two parallel systems involved in the processing of files.

Knowing the hurdles and challenges health plans had to overcome in 2020, we developed a Pandemic Playbook to help navigate the year ahead.

As ACOs face mounting pressure to take on downside risk, we take a deep dive into financial benchmarking to help maximize savings and improve quality of care.

CMS assumes plans have perfect data ready for the RAPS to EDS shift, but what are the real world effects of CMS' 0% Encounter data transition? Episource explores the implications of the 2022 Advance Notice on MA and dual-program enrollees.

On Monday, September 14th, CMS released their annual Advance Notice three months earlier than what has come to be expected. This is a move, that even though it was offered as a possibility, is one more unprecedented occurrence for 2020.

Episource's Director of Risk Adjustment & Payer Solutions, Meleah Bridgeford, reviews CMS' 2021 Rate Announcement and its effects four months into a public health emergency. How has COVID-19 affected EDS Percentages, Coding Trends, and Increased HCCs?