This interdisciplinary team will be positioned to identify and address concerns and act quickly to implement education and policy updates. Q: We're looking for ways to bring our CDI and coding teams ...

Accurate risk adjustment isn’t just a box to check; it’s now a strategic lever. Hierarchical Condition Category (HCC) coding underpins risk scores that drive Medicare Advantage and other value-based ...

"Modifying the HCC model is not a simple technical update or revision," the AMGA says. CMS recently released proposed changes to the CMS-HCC Risk Adjustment Model for payment year 2024 in February, ...

The following is a guest post from Rodrigo Martinez, MD, Senior Vice President, Consulting at Advisory Board Company. As the shift toward value-based care and risk-based contracting progresses, it ...

Geisinger Health Plan of Pennsylvania has implemented a new application to help professional risk adjustment coders uncover missed Hierarchical Condition Category codes in member charts. The ...

Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...

Two years ago, I would have told you that autonomous AI coding was too risky for risk adjustment. Today, I'm implementing it—but only after finding an approach that met my compliance requirements.