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Analytics & Accuracy: How to Improve Program Performance by Surfacing Complex Conditions

Risk Adjustment Program Performance
Episource
May 6, 2022

Accurate coding and advanced analytics are the foundation of an effective risk adjustment program, particularly when it comes to managing complex patient populations. Now more than ever, health plans are being asked to do just that—while also expanding access to care, driving patient engagement and retention, and improving health outcomes.

Organizations that are able to quickly and efficiently surface diagnoses beyond those that are easily identified, map how they affect patient populations, and pinpoint the most effective interventions can reduce gaps in care, improving financial and clinical outcomes in the process.

Key Takeaways:

  • Discuss risk adjustment challenges and population complexities, particularly in the ACA market
  • Learn the importance of implementing NLP-powered strategies to increase accuracy and surface complex diagnoses
  • Understand how to turn trends in heavily weighted codes into action
  • Learn how to improve performance across the risk adjustment continuum

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