From Retrospective to Prospective: Why Risk Adjustment Strategies Must Evolve in 2025
A healthcare organization faces mounting financial challenges as audit results reveal significant reimbursement losses. Despite providing comprehensive care, their outdated retrospective risk adjustment approach has led to HCC gaps, underreported risk scores, and lost revenue. This scenario is not uncommon—many healthcare providers struggle with delayed documentation, compliance risks, and missed opportunities to capture patient complexity […]
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