With heightened pressure for providers to assume greater risk as part of the shift toward value-based care, the importance of meeting quality targets and ensuring cost effective care delivery is now at the core of their shifting business models.
Northeast Medical Group (NEMG) (part of Yale New Haven Health System) knew they had to move from volume to value and look to new strategies to improve risk-based reimbursement and deliver improved health outcomes across their population. Through an intense focus on the accuracy of their documentation and ICD10 coding practices across their organization, NEMG was able to realize a 16% increase in their overall RAF score, prioritize and complete annual care and wellness visits, and submit risk adjustment changes to their target Medicare Advantage population within a few months. Ongoing efforts continue to focus on provider education for documentation and coding accuracy.
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