The resulting benefits span across the entire spectrum of care delivery including improved patient care and improved provider and payer performance
Irvine, CA (PRWEB)
July 27, 2017
Dynamic Healthcare Systems, a leading provider of comprehensive solutions to health plans and health systems participating in Medicare Advantage, Managed Medicaid, and Marketplace programs, today announced new capabilities of its Hierarchical Condition Category (HCC) Analytics solution. Dynamic’s analytics solution, utilized extensively by payers for many years, has now been enhanced to extend its usage to providers who, while sharing Medicare Advantage risk with health plans, are looking to improve the quality of their patient care and the accuracy of their diagnosis coding at the point of care.
These enhancements shift the responsibility for the identification of potential care gaps and coding issues from downstream payers to the upstream providers seeing the patients and doing the diagnosis coding. The resulting benefits from this shift include shortening the timeframe between patient visits and the presentation of care and coding suspects from several months to 24 hours.
Additionally, potential diagnosis coding issues and care gaps are presented directly in the patient’s medical record, thereby improving the quality of patient care and the accuracy of provider coding at the point of care. Closed care gaps and improved coding accuracy result in more accurate Medicare Advantage risk scores and improved accuracy of Centers for Medicare and Medicaid Services (CMS) payments. Inaccurate CMS payments can lead to steep CMS penalties and payment shortfalls.
“We are excited to be able to help providers who share Medicare Advantage risk with payers more effectively close their patients’ care…