As reimbursement models shift to value-based care,
effectively managing the chronic conditions of your patient population is critical to revenue cycle performance. That's why it's vital to capture the HCCs that reflect accurate risk adjustment factor (RAF) score for your patients.
- Growth of aging population and rising chronic disease increases the volume and need for value-based care.
- Medicare Advantage, ACOs, and other shared savings programs are now tying reimbursements to HCCs.
Failing to adequately capture a patient's risk through medical documentation and coding may lead to an inaccurately low level of attributed risk and eventually to reduced reimbursement.
RAF Vue simplifies HCC management and ensures accurate RAF scores.
Many HIM and CDI clients are frustrated and overwhelmed by the manual processes of managing risk-based patient data to ensure accurate RAF scores. They’re finding that lack of tools and data analytics is slowing down their progress to create an effective risk-adjusted population management strategy. While using Excel may work to manage other data, it's a painstakingly inefficient way to identify missed opportunities in HCC coding.
RAF Vue Features:
- Aggregates data at patient level
- Allows easy suspecting of patients with the greatest impact.
- Automatically calculates both reported and potential RAF scores, as well as realized gain.
- Enables CDI workflow that produces actionable data.
- Detailed reporting measures risk, identities gaps, and ROI.
- Immediate go-live: No EMR integration. Uses 837 file.
Ensuring that chronic health conditions are appropriately documented every year can have a significant effect on reimbursement. We looked at a hospital that used Excel and had no grasp on its RAF scores. UASI's RAF Vue analyzed the data and identified the following outcomes:
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