Risk adjustment requires accurate identification and reporting of patient diagnoses and comorbidities-which can be a complex and nuanced process.
However, different providers may have different levels of familiarity with the coding systems used for risk adjustment and may have varying levels of skill and experience when it comes to clinical documentation. This can lead to inconsistent coding practices, which can in turn lead to poor documentation and inaccurate risk scores.
Provider training is an important tool health plans can use to help ensure all providers within a healthcare network are using a consistent approach to clinical documentation that can minimize the risk of over or under coding and improve the accuracy of risk adjustment.
Read more in our infographic below.