Tag Archives: Quality Management

Aligning risk adjustment and quality management

Many health plans maintain separate risk adjustment and quality management programs, with purposefully siloed objectives and metrics. But aligning the two enables true transparency from data to analytics, and provides numerous benefits: Revenue growth Improved outcomes Reduced medical spend Managing at-risk populations requires health plans to have the appropriate controls and processes in place that […]
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Designing an effective integrated clinical model

As the shift to risk-sharing and value-based models of care continues, physicians, hospitals and hospital based physician group must put greater focus on better coordination of care and outcomes. They must also be capable of taking on some level of clinical and financial risk. But how do we integrate these different aspects into a single […]
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Maximize Clinical Documentation Improvement Potential for ICD-10 and Beyond

In this installment of our ongoing ICD-10 Education Series, we’ll discuss opportunities to improve clinical documentation improvement (CDI) programs as part of preparations for ICD-10 and beyond. Information is driving change in the way health care organizations provide care for patients and streamline business practices. The amount and quality of medical information available to stakeholders […]
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