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Sunday 9 December 2012

Risk Adjustment

By Adam Ross


Risk adjustment is the method used to determine how much a patient is likely to cost relative to their health status, other health issues and a variety of factors. The analysis provided by risk adjustment allows the centers for Medicare and Medicaid services as well as health insurance companies the ability to calculate how much a patient is likely to cost them over a year's time. There have already been a number of different improvements made to the current risk adjustment analytics however there are always more improvements and updates that can be put into place.

There are many different issues that we face with our current health care system, and it is the thought of many that risk adjustment analytics could play a big role in finding ways to improve this system and make it more effective. The types of solutions that are currently available for risk adjustment analytics are being looked into and focused on as a way to improve them within the current health care field. A number of professionals believe that risk adjustment analytics is something that can help to improve the fund distribution as well as help the amount of cost savings increase for the providers of the care as well as the insurance companies.

Focusing on the individual, and their specific issues, potential risks and other factors that add into the estimated yearly costs is one of the most important factors of risk adjustment analytics. One of the areas that is being focused on within risk adjustment analytics is the creation of a software that will be capable of completing accurate calculations of the overall financial risk of a particular individual or patient based on the factors presented. Currently there are many different health care companies that provide risk adjustment analytics software, however there are still a number of improvements that can be made to this type of analytics.

Another area that needs to be focused on in order to improve the capabilities of risk adjustment analytics is the recording of patient information such as interactions and services rendered by health care providers. It is necessary to have the most detailed information about the patients as a way to accurately calculate and use risk adjustment analytics. Without this information it is impossible to calculate correctly not matter how advanced the technology and software may become. It is the responsibility of both the health care provider, and the risk adjustment analytics program to ensure the accuracy of calculations.

To know more about Risk Adjustment Analytics go to Altegra Health.




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