Risk Adjustment and Payment Reform: A New Webinar

Every study of accountable care organizations recognizes that proper risk adjustment tools are critical to their success.

Without adjustments for case-mix severity and other issues, providers’ cost and quality measures can be simply wrong. For example, hospitals and physicians who treat a high number of seriously or chronically ill patients would unfairly have inappropriate funding, simply because they treat more people who are sick.

Last month, our House of Delegates declared that “proper risk adjustment” is an essential component of payment reform.

In order to take on a bundled, global payment or other related payment models, funding must be adequate, and adequate risk adjustment for patient panel sickness, socioeconomic status, and other factors is needed. Current risk adjustment tools have limitations, and payers must include physician input as tools evolve and provide enough flexibility regarding resources in order to ensure responsible approaches are implemented. In addition, ACOs and like entities must have the infrastructure in place and individuals with the skills to understand and manage risk.

On June 23, the MMS is hosting an important webinar on risk adjustment. It will cover why risk adjustment is important to your practice, its importance in the context of ACOs, global capitation, and medical home models. The webinar will also focus on a detailed description of the risk scoring and funds allocation processes.

The webinar content is particularly relevant to provider organizations that are about to enter into global payments, are already in such a program, or considering the creation of an ACO.

Click here for more information or to register.

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