HCCs and Risk Adjustment Are Aligned for Value-Based Care
An emphasis on Risk Adjustment solutions and HCCs correlates well with the shifting environment in the healthcare sector as care is in transition from inpatient to outpatient and from fee-for-service to value-based reimbursements. Demographics and diagnoses from claims data are used in Risk Adjustment (RA) reimbursements to calculate a patient's risk score or Risk Adjustment Factor score, often known as RAF score. The RAF score is said to anticipate future care expenditures. Outpatient CDI initiatives concentrating on enhancing patient records in general practitioner facilities and around the healthcare ecosystem to enhance HCC diagnosis detection are a critical component of Risk Adjustment, regardless of how big or small the healthcare institution is. The Junction of HCCs: When it comes to HCCs, one procedural decision that must be carefully evaluated is the timeline for reviewing the medical chart. The rec...