Part 1 below covers key tradeoffs and the first two of four categories of strategies that have been advanced to improve risk adjustment in Medicare Advantage. Part 2 tomorrow will cover the remaining ...

Healthcare coding has fundamentally transformed from volume-driven revenue capture to compliance-first, defensible documentation standards.

Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...

Risk adjustment could continue to draw on diagnoses from medical claims, but in a more targeted fashion that focuses on diagnoses that supply additional predictive information and are less affected by ...