With year-end initiatives, open enrollment periods and holidays, there is a flurry of activity in the fourth quarter. Now is the time to apply best practices and lessons learned in 2022 in order to position your risk adjustment plan for 2023 success. For sustained and compliant risk adjustment programmatic success, keep these three planning elements top of mind as your organization enters the final stretch of 2022:
Plan each initiative, compliance checkpoint and data submission on a shared calendar
Maintaining a shared calendar within the risk adjustment function helps on several fronts. One of the main benefits is that it increases visibility and collaboration across the RA analytics, clinical and operations groups. Additionally, creating and reviewing the calendar as a team is a great exercise in connecting the dots between siloes that are heavily dependent upon each other. Finally, as risk adjustment operations continue to evolve and become more complex, having all the major milestones and deadlines in one place helps ensure nothing slips through the cracks in 2023.
Solidify leading and lagging indicators for each initiative
Leading and lagging measures should accompany each major initiative in the 2023 RA plan to accurately gauge performance and rapidly identify issues. Leading measures often take the form of volume of completions or tasks completed, and often can be measured in real time. Completions of each initiative should be tracked at least monthly, and the ebb and flow of seasonality should be taken into consideration to appropriately measure actual performance. Lagging measures tend to take the form of quality or the outcomes of initiatives, and may take weeks or months to accurately assess. Although there are many lagging measures, accuracy of diagnosis codes from in-office assessments, in-home assessments, virtual assessments, chart reviews and data submissions should be top priority.
Closely monitor open enrollment trends and be prepared to make final adjustments to the plan
During open enrollment, there may be significant shifts in the number of beneficiaries across various products that may impact the overall disease burden of the population and RA team workloads. Changes in enrollment may necessitate fine-tuning and right-sizing the 2023 plan depending on how final enrollment settles out.
ATTAC Consulting Group has the expertise to ensure that accuracy of risk scores is always in the forefront of your organization’s risk adjustment program. With a pulse on the latest CMS and OIG trends and the knowledge of where to look, we’re uniquely positioned to aid in your organization’s risk adjustment 2023 program strategy design. Contact our experts as your organization enters the final stretch of 2022.
