Category: Data

What America Can Learn from the U.K.’s Experience with Risk Adjustment and Population Health

Andrew Raymore

  We’ve discussed on the Apixio blog how critical risk adjustment is to the functioning of a healthy insurance market in the U.S., but how is risk adjustment applied in the healthcare systems of other countries? What makes this a fascinating question is that many other countries provide health insurance for a greater percentage of […]

4 Things Risk Adjustment Leaders Need To Know About the 2018 CMS Final Call Letter

Anita Joseph

Recently, the Centers for Medicare & Medicaid Services (CMS) released its Final Medicare Advantage (MA) Part C and D Call Notice for 2018. We combed through the  notice, and here is what we think risk adjustment professionals need to know.   1. What is the final call notice and why is it important to risk […]

How We Use Machine Learning to Analyze Patient Data in Medical Records

Eric Tan, CPC, CCS

As we have covered in the first part our blog series, risk adjustment is traditionally done in a very manual and slow way. This process is time consuming and costly, not to mention that it doesn’t make good use of coders’ expertise. Because of these issues, cognitive computing can meet an important need for risk […]

How We Use Technology to Get Risk Adjustment Data Out of EHRs

Eric Tan, CPC, CCS

This is the second in a 4-part series called Intro to Risk Adjustment Technology. As we discussed in the first post in this series, traditional risk adjustment is incredibly manual. Coders will comb through thousands of pages of patient charts and look for documented chronic conditions. This process is time consuming and costly, not to mention that […]

The Path Forward for Healthcare Data is Deeper Insights on Patients and Doctors

Anita Joseph

At this point in time, it’s fair to say that healthcare data has not transformed healthcare the way many people thought it would. We have a lot of healthcare data, for sure, but we don’t make effective use of it. This is largely because efforts to leverage healthcare data have been scattered and unfocused. Are we worried about data […]

Intel and Apixio Release Big Data Analytics Whitepaper

Anita Joseph

Today, Intel released a whitepaper profiling Apixio’s innovative application of big data analytics to the healthcare space, through its risk adjustment application HCC Profiler. The whitepaper describes how Scripps Health used HCC Profiler to review 21,000 Medicare Advantage charts with increased accuracy and productivity. As Linda Pantovic, Scripp’s Director of Compliance and Performance Improvement said, “The […]

Understanding Healthcare’s Data Problem: 2015 Tech In Review Edition

Jamie Urborg

Understanding the full state of the patient is a difficult task for physicians when 80% of data is tough to access. What does it mean to only have 20% of all possible info? Play the latest version of our 20% game… 2015 has come and gone, and 2016 is here. But before we move on, let’s […]

Understanding Healthcare’s Data Problem: Album Cover Edition

Jamie Urborg

In healthcare, developing strong patient diagnosis and treatment recommendations takes time, resources and data. As patient data grows at an exponential rate, comprising an expected 25,000 petabytes in 2020, healthcare organizations are faced with the challenge of extracting and uncovering the value in their patient information. Unfortunately, 80% of patient data is unstructured in form, and inaccessible without […]

The Data Analyst Will See You Now

Anita Joseph

NPR recently wrote an article about a project NYU medical school students are required to do entitled, “Health Care By the Numbers.” In the project, students are given access to a massive data set with more than 5 million patient records. They are asked to analyze the records to draw conclusions about care quality. The […]