Can your PACE program answer the only V28 question that matters?
"Exactly how many dollars are at risk, and which diagnoses are responsible?"
Most PACE leaders know something is changing under V28. Very few can translate that change into a specific dollar exposure tied to specific diagnoses. Every downstream decision, staffing, documentation strategy, vendor spend, is being made without that clarity.
This 7-step plan exists to close that gap.
This 7-step plan exists to close that gap.
- ✅ Translate V28 from a policy update into a dollar-level exposure report, not percentages, not abstractions, actual revenue at risk by diagnosis
- ✅ Shift from volume-based coding to prevalence-driven gap identification, with a framework for aligning Population Health, Medical Leadership, and Operations
- ✅ Redesign workflows around the high-value diagnoses that now carry strategic importance under V28, with clear role ownership at each step
- ✅ Treat documentation risk as a revenue protection function, with continuous oversight, not episodic sampling
- ✅ Use automation to absorb what human teams physically cannot scale, and retrain clinicians on what still matters, continuously
Built for PACE Executive Directors, CMOs, Medical Directors, Operations Leaders, and Compliance Officers navigating V28 revenue compression.
We already have a V28 plan
Good. Does it quantify exposure in dollars, or percentages? A 3–5% RAF shift sounds manageable. A $2.4M annualized revenue gap tied to five diagnoses does not. This plan helps you pressure-test the difference.
Our coding team is handling V28
Under V28, missed diagnoses are usually a workflow failure, not a coding one. This plan aligns Operations, Medical, and Compliance leadership, because coding alone can't solve what's broken.
We've already adjusted our documentation
Documentation improvement plateaus without workflow redesign. This plan shows where the ceiling is and what breaks through it.