For Medicare Advantage and Health Insurance Marketplace health plans, CMS’ risk- and quality-based payments require them to aggregate a variety of data sources and better coordinate care.
Although these processes use multiple sources of information from the same member population, health plans have historically administered risk adjustment and quality performance functions in silos, rarely sharing data, technology, and resources. This disjointed approach results in missed opportunities to receive accurate revenue and improve the quality of health outcomes.
Bringing risk adjustment and quality performance together as one and using a consolidated foundation of data with a comprehensive analytics platform can help plans create a more strategic, unified approach to revenue and quality management.
Download this white paper to learn more.