Apixio is the market-leading technology solution for Medicare Advantage (MA) risk adjustment coding. Using HCC Identifier, at-risk provider groups performing retrospective chart reviews for MA have reduced coding time by 80%, increased coding accuracy by 20%, and improved productivity by 4 – 6X. If your ACO plans to take on MA or other value-based contracts in the future, our solution will provide a strong foundation that can evolve with your risk adjustment program.
Supporting accurate, comprehensive risk adjustment for MSSP
As more ACOs move into MSSP tracks with both upside and downside risk, risk adjustment is becoming a critical business activity. To maximize shared savings, your population’s risk must be fully represented on claims. But manually performing retrospective chart reviews, developing patient suspect lists to close gaps, and identifying provider improvement areas is time-consuming, expensive, and often ineffective.
Apixio’s Risk Adjustment Solution for Medicare ACOs uses artificial intelligence (AI) to identify risk-adjusting patient conditions that haven’t been properly documented at the point of care or coded on claims, improving your ACO’s risk capture for Medicare patients.
How we help
Benefits for ACOs
- Improved benchmark performance with more accurate submission of risk-adjusting patient conditions to CMS
- Efficient chart review process for risk-adjusting conditions missed during claims coding
- Streamlined chase list generation to inform patient outreach
- Targeted intelligence to help physicians improve documentation and claims coding