Risk Adjustment Reviews Are Your Key To Success In Value Based Contracts
Retrospective reviews of risk adjustment coding are foundational to the financial health and stability of Accountable Care Organizations (ACOs) and Medicare Advantage plans (MAPs). This is increasingly true as value-based contracts and their underlying details become more complex, coding requirements change, and the demand for qualified risk adjustment coders increases. By focusing on retrospective reviews of risk adjustment coding , you can position your organization for more accurate representation of your population and possibly better financial outcomes. What is Retrospective Risk Adjustment Put simply, retrospective risk adjustment is looking back at past claims to ensure proper diagnosis coding. The benefit is that this process can reveal gaps in your diagnosis coding of chronic illnesses that could lead to decreased reimbursement in the future. And while many ACOs and Medicare Advantage plans have a retrospective risk program, sometimes the plans themselves are inef