Risk adjustment scores and quality measures are critical factors in optimizing revenue for health plans and providers. SCIO® harnesses the data that drives CMS risk-adjusted methodologies and provides useful insights to clients to maximize revenue.
Risk Adjustment: Risk adjustment analytics aligns revenue with expected costs of care and tracks HCC trends so organizations can easily create suspect lists to support retrospective and prospective collection programs. SCIO® provides actionable information to identify and manage patient populations and their related RAF scores, driving CMS revenue.
Quality Measurement: SCIO® allows plans and providers to gain efficiencies by integrating Medicare risk adjustment and HEDIS/Stars prospective activities. Working to improve RAF scores and quality scores go hand-in-hand, and when you do both, you can have an even more significant impact on the quality of care you provide and revenue you generate.