Risk Adjustment Toolkit

A comprehensive set of risk adjustment tools backed by the industry’s leading analytics engine, all available without leaving Excel.

Risk Adjustment Analysis at your fingertips

Episource’s Risk Adjustment tools provide member and chart-level Risk Adjustment analytics capabilities directly in Microsoft Excel. By utilizing the industry’s leading Risk Adjustment analytics engine, our risk adjustment tools empower payers with immediate visibility and instant flexibility. Spot and fix coding errors easier, view your year-over-year changes in members’ risk scores, identify Dx and HCC gaps, and project risk adjustment program ROI, all within Microsoft Excel.
Risk Adjustment Tool Features:

  • Calculate member risk scores and forecast premiums based on demographic and diagnosis information
  • Perform analysis on Dx codes and/or HCCs
  • Get descriptions and reference details about Dx codes or HCCs without leaving Excel
  • Identify Year-over-Year HCC gaps and calculate their financial impacts
  • Calculate impact and ROI of incremental codes identified in risk adjustment programs
  • Full implementation of the CMS HCC Models from v22 to v24, including hierarchies, age/sex edits, and interaction codes
  • Coverage of all risk factor types (Community, Duals/Disabled, Institutional, Newly Enrolled, etc.)

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Better risk adjustment decisions in a few clicks.

By recreating many of epiAnalyst’s core functions directly in Microsoft Excel, our risk adjustment tools deliver clear and concise information about small scale projects in actionable formats, available online or off. With the Episource Risk Adjustment Toolkit, program managers and analysts can quickly and easily pull targeted risk adjustment analytics of limited-scale member populations for accurate projections, risk adjustment program ROI, and more. It’s your data, use it how and when you want.

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