Risk Adjustment Clinical Suite: The Key to Value-Based Success

 

By delivering better satisfaction, better clinical outcomes, and better population health, value-based care can transform healthcare. Effective risk adjustment is essential to success in value-based care—but for many provider organizations, achieving complete and accurate risk capture is easier said than done.

 

Retrospective reviews can help identify missed coding opportunities, but they’re not enough. Providers need to be able to uncover and correct risk gaps at every stage of care delivery, not just after claims are submitted.

 

The Risk Adjustment Clinical Suite from Edifecs leverages AI & NLP to help provider organizations close care gaps, flag risk-adjustable opportunities, and reconcile clinical data with HCC codes—without disrupting clinical workflows.

 

Watch this video to learn how we do it.