Health Plans and Managed Service Organizations Trust Affinite--™ Risk to Optimize Hierarchical Condition Category (HCC) Compliance.
Designed by clinical experts, Affinite--™ Risk applies artificial intelligence and machine learning to streamline the complexity and ensure the accuracy of HCC risk adjustment.
Frequent updates to the Centers for Medicare and Medicaid’s Hierarchical Condition Category (CMS-HCC) model for risk adjustment require ongoing improvements to a health plans’ method for calculating risk scores.
If these changes are missed or implemented poorly, health plans can incur higher costs due to missed reimbursable expenses and potentially impact the quality of care for chronically ill members.
Vital Data Technology’s Affinite--™ Risk module solves this challenge by providing a cloud-based solution – instantly updated with new risk criteria. This modular approach enables plan executives to identify member-specific risk stratification and alleviate financial and care gaps.
Key Features of Affinite--™ Risk include
- Compute DIY HCC per member daily on rolling 12 month
- Data Science AI/ML predictability of HCC scores.
- Real time forensic analysis of risk acuity gaps with real time engagement with affected provider’s patients/members.
- Development of CareFlow rules for risk stratification and engagement.
- HCC, Elixhauser and Charlson
To learn more about this HCC risk adjustment solution, reach out for a personalized demonstration.