Case studies

Relieve the burden of coding and documentation with Vatica

Provider
Value-based care

Provider members of the Kentucky Primary Care Clinically Integrated Network found support in the Vatica program at no cost. Vatica relieved the burden of coding and documentation while generating additional health plan compensation. Read our case study for the noteworthy results.

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Compliance

CMS regulations call for a prospective risk adjustment solution with PCP involvement

CMS continues to intensify oversight of Medicare Advantage (MA) risk adjustment practices with the 2027 Final Notice, significantly curtailing the use of retrospective risk adjustment diagnoses that are not supported by a qualifying patient encounter.

CMS regulations call for a prospective risk adjustment solution with PCP involvement

Resources

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on healthcare 

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Blog

Key metrics for value-based care

Value-based care (VBC) is designed to incentivize providers to improve outcomes in a cost-efficient manner. In other words, payment and quality of care are inextricably linked.

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Blog

What’s behind the move from retrospective to prospective risk adjustment?

Health plans across the country are recognizing the superior value of prospective risk adjustment programs, and rightfully so.

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Blog

Another blow to detached health risk assessments

Health Affairs recently published a study of data from 4 million Medicare Advantage (MA) members indicating that health risk assessments (HRAs) contributed up to $12 billion per year to risk adjusted payments in 2020.

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Adjust your approach to risk adjustment

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