You know the enormous impact risk adjustment has on your Medicare Advantage organization’s bottom line. But with all the encounter data involved—from diagnosis and condition codes to treatment and pharmaceutical codes—you may have no idea how to create order out of the chaos. Too many MAOs make data processing and management more complicated than it needs to be.
If you are still relying on staff to collect and process data, or if you’re trying to make old software tools work in a changing healthcare environment, you need to rethink your risk adjustment process. You can’t realize the reimbursements you are due if you keep doing things the way you have always done them.
You need a well-designed solution that addresses your current needs and can scale to meet future changes in your patient populations and government regulations.