8 SEP - OCT, 2020Nurses instead of Coders: Chart scrubbing at Atrius Health By, Judy Bleiberg Remz, Director of Risk Adjustment Programs, Atrius Health Why does it matter if the clinician notes the patient's issue as diabetes or diabetes with complications if the amount billed will be the same either way? When healthcare providers move to value-based contracts, it is important that they are paid enough in the budget for the population to cover the sum of the estimated costs of care for each patient. Risk adjustment, or scaling an average budget up or down based on the documented health of the patients, is how budgets are changed to represent the overall health of that population. Risk adjustment models consider chronic conditions and demographic information that might be valuable for determining patients' approximate health expenditures. When a clinician assesses a patient's chronic condition, this information must be submitted on a claim so that provider organizations can be fairly reimbursed by insurers.Judy Bleiberg RemzIN MY OPINION
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