DataLink Software (DataLink), a leading solutions provider that delivers interoperability, reduced costs, improved quality scores and risk adjustment accuracy, offers insights on value-based care and improved risk adjustment accuracy for high-risk members with the release of its white paper, “New Perspectives in Value-Based Care: Improving Risk Adjustment Accuracy for High-Risk Members.” This document highlights how gaining accurate identification and documentation of chronic conditions is essential to patient health, safety and the reduction of medical costs.
“The COVID-19 pandemic has underscored the importance of chronic disease prevention and care, prompting more healthcare organizations to seek strategies to improve quality and risk adjustment scores,” says Josh Hetler, executive vice president, Business Intelligence. “DataLink’s Evoke360 is a value-based care enablement solution that effectively empowers providers to identify open care gaps for proactive closure and provides payer-agnostic data to inform clinical, quality and risk adjustment programs for improved patient outcomes.”
CMS uses Medicare Advantage’s (MA) risk-adjustment model, known as the CMS-Hierarchical Chronic Conditions (HCC) Risk Adjustment model, to determine payments for MA plans. Under the model, MA plans assign each beneficiary a risk score based on medical coding that reflects the beneficiary’s medical condition. Beneficiaries with poorer health will have higher risk scores, while healthier beneficiaries will have lower risk scores. MA plans are given higher payments for beneficiaries with higher risk scores than they are for beneficiaries with lower risk scores.
Hetler adds, “Evoke360’s real-time insights align the payer, provider and patient with one solution that proactively closes care gaps to ensure a complete health status for improvements in care delivery and health outcomes.”
About DataLink Software
Founded in 2001, DataLink is a healthcare technology company that empowers better health by delivering real-time data aggregation, EHR connectivity, and dynamic dashboards and reporting to payers, providers and care partners. DataLink promotes the collaboration of multiple stakeholders across the care continuum, providing a holistic, real-time view of the entire spectrum of patient data, and its intelligent, data-driven solutions drive value by reducing the cost of care, improving quality scores, ensuring risk adjustment accuracy, and simplifying healthcare navigation. For more information, visit www.datalinksoftware.com.