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From HCC to CDPS: A Primer on Common Risk Adjustment Models

WebHSS-HCC Model. The HHS-HCC risk adjustment model (6) calculates risk scores in real-time using diagnoses from a specific period to predict costs for that same …

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URL: https://go.episource.com/bulletin/from-hcc-to-cdps-a-primer-on-common-risk-adjustment-models

Risk Adjustment 101: Everything You Need To Know

WebA risk adjustment program will analyze patient demographics and past diagnoses to determine the amount health plans should be reimbursed for taking on high …

Category:  Health Go Health

How to Identify and Apply ICD-10 Combination Codes to

WebThere’s no doubt Medicare Advantage (MA) plans and other risk-bearing entities have heard about ICD-10 combination codes, but with the increased amount of …

Category:  Health Go Health

The Good, the Bad, & the Unknown: What the Pandemic Means

WebCOVID-19 continues to create uncertainty for healthcare organizations, particularly as the new Delta variant moves across the globe. But one possible glimpse …

Category:  Health Go Health

Risk Adjustment and Value-Based Care: Strategies for

WebRisk Adjustment Beyond the Data Weeds: Analytics for Stronger Performance Across the Risk Adjustment Lifecycle. Master the complexity of Medicaid …

Category:  Health Go Health

Unlocking the True Potential of Your Risk Adjustment Program

WebBased on our analysis and program assessments that included data for over 400,000 members, we found that plans on average showed a risk adjustment factor …

Category:  Health Go Health

Is 95% Coding Accuracy Good Enough

WebIn today’s challenging landscape of rising costs and growing compliance risk, 95% accuracy is no longer enough. Second-level reviews are an excellent way for health …

Category:  Health Go Health

A Holistic Approach to Help Providers Transition to Value

WebThe Centers for Medicare & Medicaid Services (CMS) has a goal for 100% of providers to accept downside risk by 2025.

Category:  Health Go Health

Episource Encoder

WebStreamlining Healthcare Coding and Enhancing Revenue Forecasting in the Face of the CMS-HCC V28 Model Transition. Shortly after the version 28 of the Hierarchical …

Category:  Health Go Health

How to Conduct Clinical Suspecting to Capture HCCs

WebAs a primer for this post, here is a quick definition of the process being discussed: Clinical suspecting is the process of identifying possible conditions that are …

Category:  Health Go Health

How NLP Engines are Fulfilling AI’s Promise in Healthcare

WebEasing Up Workflows. AI/NLP engines turn the expertise of the medical coder into a more useful asset for healthcare plans by enabling these professionals to focus on …

Category:  Medical Go Health

How ACO Risk Adjustment Analytics Can Improve Care, Close

WebTherefore, working with a risk adjustment analytics partner can help ACOs identify missing HCCs, close gaps, and better manage care for patients, both …

Category:  Health Go Health

3 Steps to Closing HEDIS Gaps Early

WebThey say the best predictor of future behavior is past behavior. That’s why, with Q3 rapidly approaching, now is the time to bring non-compliant members into …

Category:  Health Go Health

Episource Bulletin

WebA large health plan in Puerto Rico turned to Episource for reconciliation and submissions expertise. Be the first to know about new risk adjustment insights to build or refine your …

Category:  Health Go Health

Episource Careers Homepage

WebEpisource is a place where we get an opportunity to learn multiple projects. Team leads and managers are very supportive. Medical Coder. Chennai, Tamil Nadu. Very nice and …

Category:  Medical Go Health

The Best of Both Worlds: Balancing Retrospective

WebThe healthcare industry is quickly moving towards value-based care (VBC) — a model expected to grow at a compound annual growth rate (CAGR) of 20.3%, reaching …

Category:  Health Go Health

Key Differences in Pediatric Risk Adjustment

WebDOWNLOAD. Approximately 20 percent of pediatric patients will have a risk-adjusting condition as compared to 65 percent of the Medicare Advantage population. …

Category:  Health Go Health

Episource Benefits and Perks

WebVarious Health and Dental Plans. Vision Insurance. Company-Paid Long Term Disability, Basic Life, and AD&D Insurance. Voluntary Short-Term Disability.

Category:  Health Go Health

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