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Reyann Davis

Gettin' Risky between 24, 28, & Rx


Excited to share our latest tool designed to align seamlessly with MSSP HCC quarterly table for ACOs. Our crosswalk tool incorporates essential notes on V28 and RxHCC considerations, empowering you to enhance your risk score strategies and educational materials.

Download it for free and let's exchange success stories on how you're leveraging this powerful tool!


Is your risk score strategy up-to-date with V24, V28, and RxHCC considerations? For provider networks engaged in alternative payment model contracts, integrating the v28 conversion into your operations is likely underway. However, have you also incorporated RxHCC into your strategic discussions, particularly if you bear Part D MA risk in any of your contracts?


Looking ahead to 2025, the Part D Risk Score will carry more significant weight on diagnosis capture, mirroring trends in medical risk scoring. While there is overlap between medical and prescription risk scores, it's not a one-to-one correlation. It's an additional layer of complexity that we must factor into our APM strategies.


Ensuring compliance is paramount in the current landscape, given the heightened scrutiny from recent whistleblower lawsuit surrounding risk score capture programs. Do you have a robust compliance plan in place to guarantee the accurate capture of diagnoses and supporting documentation?

 

Take a payer-agnostic approach to identify opportunities for improvement in your risk score capture processes. By doing so, you can enhance your performance across all lines of business, maximizing benefits and ensuring long-term success. #MSSP #ACO #CIN #Risk Score #APMStrategies #ComplianceExcellence


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