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Advance Possibility

Remember the Member: How the V28 CMS-HCC Model and Value-Based Care Are Putting the Focus on Patient Outcomes

Patient care
Episource
May 9, 2024

Health plans across the country are grappling with significant changes to their operating models. Two of the most significant changes currently unfolding are the drive toward value-based care and the introduction of the V28 Hierarchical Condition Category model. Together, these two developments have created urgency for health organizations to deliver better, more cohesive experiences to patients.

These changes, however, have posed some new challenges for health plans and created some far-ranging consequences. In this whitepaper, we take an in-depth look at the following:

  • Initial results we’re seeing across the industry as a result of the introduction of the V28 model.
  • The specific impacts we’ve seen on both patient care and coding.
  • Other factors that are also affecting risk adjustment.
  • Practical recommendations all health plans can implement to succeed with both value-based care and the V28 HCC model.

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