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Predictive models and population health risk: Payment (part one)
Latest News

In today’s population health environment, risk-adjustment models are being used for both payment and population health management. In part one of this two-part blog, Richard Fuller and Dr. Norbert Goldfield explore the application of risk-adjustment models for capitated payment. They put forth the position that predictive models are vastly inferior to concurrent models for payment and that the use of concurrent models in conjunction with quality outcomes-based targets provides both superior incentives and increased payment accuracy.

Read the blog post here and let us know your opinion in the comments section.

Population Health Requires New Options for Managing Patient Care

As a Medicare Pioneer ACO participant, reducing hospital readmissions is a priority for Montefiore Medical Center. Identifying patients at high risk, however, can be a challenge without the right tools. Using 3M Clinical Risk Grouping (CRG) Software, Montefiore stratifies and assigns a risk category to all patients in the ACO to identify patients that need immediate care to prevent hospitalizations.

Read more at Health Data Management.

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What is nosology? No, it actually doesn’t have anything to do with your nose. Nosology is commonly defined as simply “the branch of medical science that deals with classification of diseases.”

See how our expert nosologists know how to help resolve your coding problems and let you get back to work.

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