What does risk adjustment look like from a provider's perspective? In this episode of The Pulse, Lori Cox and Rhonda Buckholtz dive into the risk adjustment program and why it appears to be broken. They explore the challenges providers face when it comes to risk adjustment and explore potential solutions to these issues, including renegotiating contracts, additional education, and population-based care.

From Contracts to Coding: The Challenges of Risk Adjustment

On this episode of The Pulse, host Lori Cox teams up with guest Dawn Carter to discuss the crucial role of social determinants of health (SDOH) in shaping health outcomes. Did you know that SDOH account for a staggering 80 to 90% of health outcomes? Lori and Dawn examine the five major domains of SDOH. They also highlight the importance of appropriate screening tools, such as P.R.E.P.A.R.E., for improving documentation and effective data collection. With nearly 60% of individuals reporting that they have never discussed SDOH with their healthcare providers, Lori and Dawn emphasize the need to raise awareness and facilitate conversations around SDOH to ultimately drive better healthcare outcomes.

From Awareness to Action: Tackling Social Determinants of Health

Episode 79 host Daniel J. Marino speaks with Gene Rondenet and Paula Gallagher on how data and information critical to proactively build a prospective risk model is key to to manage the potential risks of health care cost increases and prepare the organization for the future.

As more and more provider organizations engage in risk-based contracts, including Medicare Advantage, understanding  quality and performance along with clinical workflow integration  is critical to contract success. On the third episode of this three-part series focusing on risk-based contract and performance, Marino invited two special guests from QRC to join the show to  dive deeper into Risk Adjustment Factor (RAF) scores and the impact of Hierarchical condition category codes (HCCs).  

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Value-Based Care Insights

Value Based Care Insights: Building Quality and Performance Models for Risk Contracting  Success

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Healthcare NOW Radio and Podcast Network offers discussions on the latest developments and trends impacting the industry including: health tech, health IT, healthcare innovation, healthcare policy, healthcare data security, telehealth, interoperability, biotech, med tech, value-based care, pharma, healthcare compliance, and much more. Shows are hosted by industry thought leaders. Guests are a "who's who" across the healthcare spectrum.  The listening audience is predominantly physician and hospital-based, and the healthcare industry at large.

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New tracks tagged #risk adjustment