by Jon Rogers, Sr. Consultant, Risk Adjustment As the fourth quarter approaches, managed care organizations (MCOs) should focus on optimizing their risk adjustment in-office assessment (IOA) processes to ensure accurate patient assessments, which are crucial for both appropriate revenue realization and quality care management. The following comprehensive
Read More →by Jon Rogers, Sr. Consultant, Risk Adjustment As we move through the second half of 2024, managed care organizations must prioritize member engagement, especially for individuals with chronic conditions. This period presents an opportunity to embrace strategies that encourage essential healthcare visits, such as annual wellness and
Read More →by Jon Rogers, Sr. Consultant, Risk Adjustment As we reach the midpoint of 2024, managed care organizations (MCOs) must take a close look at their In-Home Health Assessment (IHHA) programs, which play a critical role in managing the health of Medicare Advantage and Affordable Care Act populations.
Read More →by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment Telehealth has been around for decades, but the COVID-19 pandemic thrust it into the spotlight when patients couldn’t see practitioners in-person. Suddenly, telehealth via video, audio, text, and email became a
Read More →An insightful webinar exploring the power of collaboration between providers and health plans to achieve accurate risk-adjusted compensation. While providers and health plans may have different perspectives, there are numerous synergies and opportunities to use data analytics and drive value for patients. We delve into how providers
Read More →by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment CMS recently announced its Innovation in Behavioral Health Model, intended to “improve quality of care, access, and outcomes for people with mental health conditions and substance use disorders in Medicaid and Medicare.”
Read More →by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment As CMS continues to evolve its Medicare Advantage risk adjustment methodology, significant changes have been made to the behavioral health Hierarchical Condition Categories (HCCs). Starting with the 2024 payment year, the
Read More →The success of any healthcare organization hinges on its ability to consolidate resources, share knowledge among teams, and promote collaboration. In one example of collaboration for the greater good, let’s explore the crucial role of case management in risk adjustment. Here are six ways your plan can
Read More →– by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment Leading healthcare organizations are developing strategies to align their programs and streamline the process of gathering crucial data to better serve beneficiaries. With the goal of achieving population health, managed
Read More →– by Lynn Kryfke, MSN, RN, Sr. Consultant, Risk Adjustment | Jon Rogers, Sr. Consultant, Risk Adjustment The CDC defines Health Equity as the state in which everyone has a fair and just opportunity to attain their highest level of health. Despite progress, health disparities remain a
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