ACOs & The Importance of Risk Adjustment Coding in MSSP
October 22, 2021
CMS released its final Medicare Shared Savings Program rule, called “Pathways for Success” for ACOs. The new rule is designed to help establish a path toward risk. CMS = Centers for Medicare & Medicaid Services || MSSP = Medicare Shared Savings... Read more
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Sutter Health Settles with DOJ for $90 Million
September 14, 2021
We recently published a white paper on RADV audits and the importance of strict HCC compliance. A few weeks later, the Department of Justice announced a groundbreaking $90 million settlement with p... Read more
Live with Dr. Kazi - How HCC Coding is Good For the Country
September 8, 2021
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Live with Dr. Kazi - How HCC Coding is Good For Providers
September 1, 2021
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Work Load Root Cause of Physician Burnout, Study Finds
August 26, 2021
One pillar of The Quadruple Aim is to Improve the clinician experience. Even before the COVID crisis, Physician Burnout has been a growing concern. And after 18 months of increased workload and stress, the problem is getting worse, not better. The Joint Commission Journal on Quality and Patient Safety recentl... Read more
Live with Dr. Kazi - How HCC Coding is Good For Patients
August 24, 2021
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Top 5 Takeaways from HCC Compliance RADV Audit White Paper
August 16, 2021
Planning Ahead For Strict HCC Compliance Protocols
Key Findings From 400 RADV Audits, 2011-2021
What is a RADV Audit?
The Medicare Risk Adjustment Validation Program (RADV) was created to identify and correct past improper payments to Medicare providers an... Read more
The AAFP is a great first-stop for information on Risk Adjustment and HCC Coding. And although this article is a few years old (2018), their take on HCC Coding and Risk Adjustment preparedness is both unique and extremely helpful. First, they lay out what Risk Adjustment is and how it works. Then they tie it in with IDC-10 codes and HCC coding, to paint—with a broad brush—the full picture o... Read more
Value-based Care Contracting 101
June 21, 2021
Fee-for-service contracts continue to be a challenge for VBC. The pandemic led to a drastic reduction in volumes that impacted FFS contracts revenue ($15B loss due to volume dips). During the pandemic, organizations with value-based contracts were able to pivot operations to maintain revenue even when the volumes dropp... Read more
