Risk adjustment is complex and labor-intensive

To get a complete picture of risk, you need to understand your entire population — that’s no easy task. Even when you’re equipped with all the relevant data, from claims to clinical information, it’s labor-intensive to transform them into actionable insights. Add to that the difficulty of changing providers’ documentation and workflows and risk adjustment becomes a formidable challenge.

Out of the box risk adjustment — powered by a single, centralized platform

Our centralized platform aggregates data from claims and clinical records, including data from labs, assessment, notes, medication lists, vitals and other sources.

As your teams work, our risk adjustment engine continuously runs in the background applying over 17,000 rules and using advanced analytics to spot suspected risk gaps. Arcadia provides fully traceable details for why a given diagnosis was inferred, increasing provider trust in the insights. We dive deep into the data, covering chronic conditions linked to different risk adjustment models, including CMS-HCC, HHS-HCC, UCSD, CDPS, and Johns Hopkins ACG.

The suite of tools for risk adjustment

Our powerful, centralized risk platform aggregates and integrates data from multiple sources, and delivers the information you need within your existing workflows. Stakeholders can access the information they need, when they need it, through our suite of risk adjustment tools:

  • Patient Registries surface lists of patients with open gaps and pending appointments, so clinical staff can set scheduling priorities, document care properly, and providers can close risk gaps when patients present.
  • Arcadia Assess drives improvement in risk diagnosis coding, quality measure performance, and managing annual wellness visits with simplified workflows
  • Arcadia Desktop delivers comprehensive patient data — inclusive of risk gaps — sourced from the Arcadia platform at the point of care via EHR overlay.
  • Arcadia HCC Risk Suspecting App, currently available in the Epic App Orchard, surfaces suspected, historical, and persistent documented conditions within providers existing EHR workflows.
  • Arcadia Engage generates outbound campaigns to collect health risk assessments and other information.
  • Arcadia Vista gives risk adjustment analysts a concise overview of how their network of providers is performing against targets, via prebuilt dashboards and scorecards developed in partnership with VBC pioneers. Insights include both population-wide and member-level risk — by contract type, provider group, and conditions.
  • Arcadia Bindery enables centralized analysts and risk adjustment teams to build scorecards and distribute them across the network to engage providers, influence behavior change, and improve performance.

The result? Risk gaps close. Reimbursements rise. Providers get a more accurate picture of patient populations. And caregivers can spend less time on administrative tasks, and more time on providing care to the patients who need it most.

How Arcadia can help organizations improve risk adjustment programs

Download the executive brief to learn more about how we do it, or,

Contact us today for a no-obligation demonstration.