CASE STUDY: Provider Engagement & Data Capture

Our CEO, Manu Uppal, will be giving a presentation at 11:00 today at the 2nd Annual Medicare Risk Revenue Management Conference in Ft. Lauderdale, Florida.

11:00     CASE STUDY: Provider Engagement & Data Capture

Many Medicare Advantage Health Plans Pass Up On Millions of Dollars in Risk-adjustment revenue each year. Is yours one of them?As UPMC continues to increase its risk-adjustment revenue, Provider Engagement has proven to be a critical element. While health plans depend on providers to verify members’ chronic conditions, providers themselves have little incentive or education to change their workflows to code for HCCs. The promise of prospective HCC reconfirmation, long an alluring but elusive target, may be within grasp. As this case study shows, the key to capturing those risk adjustment dollars is in shaping provider behavior – through a combination of provider engagement, a carefully designed incentive structure, and a simplification of the information exchange between payer and provider.