Accurate Patient Documentation Remains Key to Health Plan Success

May 15, 2017 Inovalon

In the midst of continued transition in the healthcare industry, including potential changes to healthcare policy, for now, all CMS rules and regulations, including the Affordable Care Act, remain in place.

Regardless of when — or if — any legislation changes in the future, comprehensive patient data and accurate documentation of disease progression are key to more efficiently and quickly improving care quality and financial performance in 2017 and beyond.

To accelerate speed to value, healthcare organizations need a modular, integrated approach to documentation. But how can you ensure you’re appropriately leveraging the data you are collecting to make the most impactful changes?

Modularity, Flexibility and Integration

An adaptive, flexible and integrated risk adjustment accuracy platform is needed to deliver actionable insights into patient data and drive meaningful improvements in today’s complex healthcare landscape. Technology that constantly refreshes the analytics so that you aren’t seeking to close gaps in care that have already closed allows for a more efficient and holistic look at your patient data.

While an end-to-end solution for risk adjustment accuracy programs may be ideal for some organizations, for many, taking a modular approach by completing work in-house or using more than one third-party vendor can offer the flexibility and customization they desire. Platforms that seamlessly integrate with your current system allow you to integrate only the parts of the process that you can’t — or don’t want — to do on your own.

The Benefits of Comprehensive Patient Data

The benefits of accurate and timely documentation are clear.

More accurate information: With the Affordable Care Act and the healthcare marketplace came a flood of patients, many of whom are new to physicians. A robust risk adjustment accuracy program arms the physician with a more accurate assessment of each patient, connecting them to a physician at the right time in the right place, supporting greater patient satisfaction and improving overall health outcomes.

Improved care: For physicians and health plans across the ecosystem — Medicare Advantage, managed Medicaid and commercial ACA — accurate and comprehensive data means more efficient and personalized care as physicians have greater insight into their patient population, which supports their quality goals and clinical outcomes.

Comprehensive patient data — and the essential role it plays in improving clinical and quality outcomes and financial performance across the healthcare ecosystem will continue to play an integral role in the transformation of healthcare as the industry adopts value-based paradigms.


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