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Measurement in healthcare is a requisite tool for keeping track of progress and helps navigate the route leading to improvement. When the measurement of public reporting is required, the efficacy of measuring processes is constrained without meaningful management and coordination. The billing and administration system in healthcare is responsible for eliciting the metrics used in Quality Reporting . For driving the elements that might be useful in improving these metrics, there is a need to uproot strength from current clinical improvements. A Quality Reporting Program is designed to assess the quality of care provided to patients, ensuring that patients get the proper care at the right time. On the one hand, with the help of quality reporting, providers can evaluate how often they meet a particular quality metric. While on the other hand, public reporting helps patients choose the right place to receive care. Quality Reporting in healthcare has a positive impact, as it gives a pic

Regardless of remarkable advancements in medicine and science, scores of gaps are fabricated in healthcare, and such voids still exist around the globe. Diverse and collective efforts of organizations and providers are needed to address deep-rooted disparities in the healthcare system . Health Equity can be attained if policymakers have prompt dialogue and efforts to bring forth transformative ideas and supporting solutions. What is Health Equity? Improving health worldwide requires a focus on equity, i.e., equal access, care, and patient outcomes. Health Equity means ensuring that everyone gets access to affordable and high-quality care regardless of race, ethnicity, age, gender, age, geographical, and socioeconomic status. It is crucial to seek the answer to What is Health Equity? to foster the communities at high risk of health barriers and disparities with better health care facilities and outcomes,  To achieve the aim of promoting Health Equity in the USA and remediate

The Hierarchical Condition Category (HCC) risk adjustment framework was first introduced by the Centers for Medicare and Medicaid Services (CMS) in 2004 to risk-adjust Medicare fee for service payments to private health insurance providers of Medicare Advantage plans. Since then, a variety of value-based pay models, such as ACOs, Direct Contracting, Comprehensive Primary Care Plus, and several others, have refined and modified the Risk Adjustment Solution and HCC Coding approach to include patient associated risk adjustment.  HCC Coding is essential to the financial sustainability of a healthcare facility since it is a critical and essential component of Risk Adjustment Solutions. HCCs provide a comprehensive picture of a patient's health status, only if the codes are appropriately recorded. Besides this, it frequently leads to a significant rise in payment to cover the cost of delivering treatment through value-based programs. HCC Approach's Conceptual Model HCC Coding is a hi

CMS employs risk adjustment to reflect the changes in beneficiary-level risk variables that might impact better health outcomes and medical expenditures, independent of the care offered. Risk Adjustment Solutions are essential to the healthcare industry's financial and clinical facets. The government is offering healthcare for a large section of the population through value-based care programs, including Medicare, Medicaid, and the ACA exchange. These models depend on a method known as risk adjustment, a tool used in finance to calculate the cost of providing healthcare to a covered population. Risk Adjustment Methodology Risk adjustment is a mechanism for predicting healthcare expenses that compare a person's health state to a number known as a risk score. By covering members with projected lower healthcare expenditures, the risk to a health plan that ensures members with high healthcare usage is adjusted. Risk Adjustment Solutions Risk adjustment analytics and data