Home The landscape of Risk Adjustment Data Validation (RADV) audits is shifting rapidly. With CMS doubling the number of audits and eliminating past leniencies, health plans must be proactive, not […]

Home The Centers for Medicare and Medicaid Services (CMS) Hierarchical Condition Categories (HCC) model plays a crucial role in risk adjustment for Medicare Advantage (MA) and other health plans. CMS […]

Home Accountable Care Organizations (ACOs) are at the forefront of healthcare’s shift toward value-based care, aiming to enhance patient outcomes while effectively managing costs. To achieve these ambitious goals, ACOs […]

Home As the healthcare industry transitions more towards value-based care, optimizing clinical operations within Accountable Care Organizations (ACOs) has become essential for achieving sustainable success. With a focus on process […]