Why Every ACO Needs A Scalable Risk Adjustment Solution?
Healthcare payment models are shifting fast. Value-based care contracts now make up over 40% of all healthcare payments, putting Accountable Care Organizations (ACOs) under pressure to optimize their Risk Adjustment Solution strategies immediately. What Makes Risk Adjustment Critical for ACOs? Risk adjustment software helps ACOs predict patient costs accurately and receive proper reimbursements from payers. Without it, ACOs face financial losses when treating high-risk patients whose care costs exceed standard payment rates. Here's what this really means: Medicare Advantage plans use risk scores to determine payments. A patient with diabetes and heart disease should generate higher reimbursement than a healthy 30-year-old. ACOs that miss these coding opportunities lose money on every encounter. How Do ACOs Currently Handle Risk Adjustment? Most ACOs rely on manual processes that create bottlenecks: Chart reviews take weeks to complete Coding errors lead to payment...
