Risk Adjustment and Telehealth in the Time of COVID.

While the ongoing public health emergency continues to place a significant toll on our entire healthcare system, it has disproportionately affected the health of the Medicare-age populations. In turn, the crisis has a new target: Medicare Advantage reimbursements.

The underutilization and delays in services for beneficiaries is going to have a negative effect on Risk Adjustment Factor scores. Because risk scores are expected to decrease for MA plans (and the commercial HHS model), identifying and addressing documentation and quality gaps will be essential to your organization’s financial health. That’s in no small part because our ability to uncover the most accurate risk picture will be vital to obtaining the necessary reimbursement.

Understanding that, we wrote a new eBrief, “What Impact has COVID-19 had on Risk Adjustment?” where we dive into the latest guidances affecting RAF scores, the administrative flexibilities available to you, and what steps can be taken to mitigate the impact of underutilization. Download it now, to understand:

• Which Risk Adjustment Data Validation Changes You Should Know About
• What to Expect for Star Ratings and the 2020 CMS-HCC Model
• How to Mitigate the Risk Adjustment Impacts of Your Population