Whether you are an experienced coder in risk adjustment or seeking better understanding, this course will take you through the fundamental principles underlying Medicare Risk Adjustment coding.
Risk adjustment is a component of the new health care reform law that is designed to improve coverage, preserve consumer choice and improve quality of care for patients. It currently applies to Medicare Advantage plans and Medicare prescription drug programs. The Patient Protection and Affordable Care Act has established a risk adjustment system for plans in the commercial individual and small group markets.
With the increase of Medicare Advantage plans and inclusion of risk adjustment models in the ACA, proficiency in selecting diagnosis codes and how it relates to risk adjustment models including Hierarchical Condition Categories (HCC), Chronic Illness and Disability Payment Systems (CDPS), and blended models is a valuable skill. There is a strong emphasis on the HCC model in this course because it is one of the most recognized.