There are three 3 things every successful VBC organization knows about Risk Adjustment. That Others Don't Want them? Here they are...👇🏻 1) Successful VBC Organizations: Have leaders who deeply understand the interconnections within risk adjustment programs. Other VBC Organizations: Shield leaders from too much detail about risk adjustment. 2) Successful VBC Organizations: Recognize that coding is just one aspect of risk adjustment. Other VBC Organizations: Equate risk adjustment solely to coding. 3) Successful VBC Organizations: Include a clinician champion as part of their team. Other VBC Organizations: Rely solely on great coders without clinical support. So, remember…You’re doing something very important. Spend time ensuring your leaders truly understand the intricacies of risk adjustment. What else do you think is important? Drop it in the comments.
Thank you Gaby for sharing this. I have seen under the "other"category of VBC Organizations the same approach from leadership where they rely details to middle managers who will unlikely move the needle as they are very busy in their day to day operations dealing with the additional pressure of being short staffed. To drive change into a VBC model, leaders should understand the details and the data to make informed decisions and be agents of change!
Julita Mir, MD
2mo
All three are critical. Please dont tell your providers they just need to code better, if u dont understand the work. Coding is only a piece of the puzzle and you need all! Thanks Gaby
Isolation. Risk Adjustment is an integral part of premium revenue but it’s a part of a robust HIM strategy that cover everything, from clinical to coding to revenue to quality and so on so forth !! Do not separate them !!
Sonal Mankodi
2mo
Great points Gaby. Many organizations are being short sighted by not including physicians in the leadership teams and this will inevitably lead to less successful outcomes.
Optimizing Care Delivery | Tinkering in AI
2moGreat orgs also don't try and have physicians and providers close all HCC gaps during any patient visit. When there are known gaps, thoughtful workflows need to be developed so that diagnoses are addressed in the appropriate visits with the appropriate individuals. It's not always in the interest of a PCP to address cardiovascular items when the patient is regularly seeing a cardiologist.