Precision Risk Adjustment Analytics for Enhanced Healthcare Management
In the evolving landscape of healthcare where emphasis is shifting towards value-based care, health plans and payers are increasingly focusing on optimizing patient health outcomes and reducing administrative waste. Precision risk adjustment analytics offered by Veradigm's Risk Adjustment Analytics solution play a pivotal role in achieving these objectives. This advanced analytics tool provides a range of benefits including confirming chronic illnesses and preexisting health conditions, detecting unconfirmed patient diagnoses, enabling early treatment interventions, and targeting appropriate risk adjustment strategies. By leveraging large datasets and advanced algorithms, Veradigm equips health plans and payers with the tools necessary to succeed in Managed Medicaid, ACA Commercial, and Medicare Advantage markets.
Monitoring Financial Impacts and Closing Gaps Effectively
Veradigm's Risk Adjustment Analytics solution empowers health plans and payers with real-time visibility to monitor and manage risk adjustment revenue, bridging the gap between actual performance and budgeted targets. The solution offers comprehensive dashboards that display real-time risk scores, population-level gap closure opportunities, and performance summaries by various metrics. By identifying and prioritizing gap closure opportunities through confidence-adjusted risk scores, organizations can efficiently allocate resources towards high-yield interventions, ultimately saving costs and enhancing financial reimbursement.
Optimizing Gap Closure Strategies with Dynamic Intervention Planning
Accurate diagnostic coding is crucial for both patients and health plans, yet errors in ICD-10 coding and underreported chronic conditions are prevalent issues. Veradigm's Risk Adjustment Analytics employs Dynamic Intervention Planning to identify coding discrepancies and recommend optimal intervention strategies for efficient gap closures. By utilizing predictive models and Big Data mining, the solution ensures precise detection of errors and targeted intervention planning. Through dynamic intervention strategies, health plans can maximize financial impact, specifically in ACA Commercial, Medicare Advantage, and Medicaid markets.
Maximizing Financial Performance with Veradigm Risk Adjustment Analytics
Veradigm's Risk Adjustment Analytics solution goes beyond traditional financial reporting by assisting risk-bearing entities in predicting Medicare Advantage risk adjustments, calculating Risk Adjustment Factor points, and monetizing gap closures. The solution's Financial Reporting Suite offers insights into individual contract performances, revenue impact projections, and optimal intervention strategies. By leveraging Veradigm's analytics capabilities, organizations can enhance financial performance, increase reimbursement across all lines of business, and navigate the intricacies of financial reporting effectively.