Category: All

The RISE Nashville 2017 Keynote Address: “Politics: From the Top and the Inside and Its Impact on the Healthcare Landscape”

Andrew Raymore

One of the most anticipated presentations at the 2017 RISE Nashville conference was the keynote address by Howard Fineman, Global Editorial Director of The Huffington Post and an analyst for NBC News and MSNBC. A somewhat politically charged speech, it was as frank and hard-hitting as Mr Fineman is known to be. Below are our […]

Why is Risk Adjustment Important to the Affordable Care Act?

Andrew Raymore

You may have heard what happened at a recent town hall meeting about the Affordable Care Act (ACA) in Tennessee. A woman stood up and said, “As a Christian, my whole philosophy in life is to pull up the unfortunate” adding “So the individual mandate, that’s what it does: The healthy people pull up the […]

Ten ICD-10 Codes for Winter

Andrew Raymore

  Jack frost still nipping at your nose? I’ve got some bad news for you. Today is Groundhog Day, and unfortunately the little guy saw his shadow and we can expect 6 more weeks of winter (no, seriously the Weather Channel reported on this).   So we’re in for a tricky time, and we hope […]

You Should Care About Risk Adjustment

Andrew Raymore

Risk adjustment (RA) sounds relatively non-descript; an industry that identified on a color wheel would be a solid beige, or a respectable eggshell. Little-understood and unsexy as it appears, however, RA is critical to the functioning of the insurance industry, the healthcare system, and to the wellbeing of nearly every American family.   Keeping Medicare […]

Top 5 Questions Facing Risk Adjustment in 2017

Anita Joseph

From the looks of it, 2017 will be a big year for risk adjustment. There is a new administration in power in Washington, which will have far-reaching implications for the entire healthcare industry. And the risk adjustment space specifically will have to look inward, as it manages the currents of technological change and pries itself away […]

Apixio CEO Talks Data and Healthcare in Tech Podcast

Anita Joseph

Calling all podcast listeners! Apixio CEO Darren Schulte, MD is featured in the latest episode of The Tech Blog Writer. Download the full episode to hear what Dr. Schulte has to say about leading the data-driven revolution in healthcare. Find the link here.

Conquering Commercial Risk Adjustment

Anita Joseph

Risk Adjustment an Important Business Factor for Commercial Exchange Plans In theory, the commercial risk adjustment program was intended to help insurers taking on the heaviest load from the commercial health exchanges. Health insurers would submit risk scores for each enrolled patient to HHS. HHS would calculate an average risk score for each plan and then mandate cash […]

3 Reasons to Care About Commercial Risk Adjustment

Anita Joseph

Participating in the commercial insurance exchanges isn’t easy. Plans have to develop a strategy for selling to individuals, set premiums, explain their network offerings to an entirely new consumer set, and orchestrate care for an unexpectedly sick population. Plus, they do all this in the face of intense public pressure and scrutiny. It’s no wonder […]

How A Veteran Coder Used Apixio’s HCC Profiler to Eliminate Data Entry Error and Double Productivity

Eric Tan, CPC, CCS

A veteran HCC coder, Gloria Rodriguez has seen the pros and cons of many approaches to HCC coding. At the beginning of her career, she “chased” and reviewed paper patient charts. Next, she reviewed electronic records through the EHR system or scanned PDF charts. Gloria currently reviews charts using Apixio’s HCC Profiler application. By using […]