Inside Angle

From 3M Health Information Systems

Tag: risk adjustment

Grethen MillsGretchen Mills

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Why risk adjust?

Aug. 1, 2022 / By Gretchen Mills

Risk adjustment is used primarily to predict health care costs based on the relative risk of members or patients. Risk adjustment is designed to mitigate the impacts of potential adverse […]

Clark CameronClark Cameron

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3M HIS methodologies help state Medicaid programs across the U.S.

July 15, 2022 / By Gregg Perfetto, Clark Cameron

Explaining what we do for 3M isn’t always easy. Truth is, for most 3Mers, the minute you tell someone that you work for 3M, they ask you if you make […]

Richard WetherbeeRichard Wetherbee

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HCCs: An awareness perspective

April 6, 2022 / By Richard Wetherbee

The idea that, at some point in each of our lives, we may become acutely ill, eventually leading to the development of a chronic medical condition is a very real […]

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The gestalt of value-based care

Nov. 17, 2021 / By Matthew Ferrara

Gestalt is defined as: “Something that is made of many parts and yet is somehow more than or different from the combination of its parts.”  Long ago, I remember attempting […]

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Back to basics: HCCs 101

April 30, 2021 / By Chris Berg, RHIA

Hierarchical Condition Categories (HCCs) have been used in the Centers for Medicare & Medicaid Services (CMS) risk adjustment payment model since 2004. That’s 17 years! More and more HIM professionals […]

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Data-driven approaches are essential to assessing COVID-19 risk

June 3, 2020 / By Megan Carr

As we all face the reality of day-to-day life during a pandemic, I consider myself in the lucky category. My husband and I may struggle as we manage two full-time […]

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How well does the CMS-HCC risk adjustment model predict future expense?

Aug. 26, 2019 / By Samuel Young, MD

In my previous blog, “Demystifying Medicare Risk Adjustment,” I introduced the model that the Centers for Medicare and Medicaid Services (CMS) uses to predict future Medicare Advantage health expenditures—the CMS-HCC […]

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HCCs: The importance of coders

July 26, 2019 / By Karla VonEschen, CPC, CPMA

After attending an AAPC presentation last year, I published a blog about HCC coding. Since then, I have continued to dive into the world of HCCs. To follow up on […]

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Meaningful outcomes comparison requires risk adjustment, but the risk adjustment needs to achieve its purpose

July 24, 2019 / By Richard Fuller, MS

Risk adjustment is a correction applied in hospital performance measurement to account for the contribution of population characteristics that are beyond the control of the hospital. The effects of these […]

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Implications of the 2019 Medicare Advantage Part 1 Advance Notice

Jan. 10, 2018 / By Gretchen Mills

On December 27, 2017, CMS published Part 1 of this year’s Medicare Advantage (MA) Advance Notice highlighting proposed changes in MA payments for 2019. CMS requires comments on this Part […]

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Value-based payment means risk adjustment for effective revenue cycle management

May 3, 2017 / By Kristine Daynes

Value-based payment models are attracting attention for risk adjustment methodologies, especially HCC risk adjustment, which is used to calculate cost benchmarks for Medicare Advantage and other CMS payment models including […]

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Pay for better risk-adjusted outcomes and let’s cut down on waste

April 19, 2017 / By Richard Fuller, MS, Norbert Goldfield, MD

While Congress is finding it difficult to reach consensus on how to improve health care in the United States, the one thing we all can agree on is that ever-rising […]