Control Risk

Maintaining or appropriately increasing risk scores that accurately reflect the attributed population’s acuity of illness is a critical component in understanding appropriate spend and utilization across the population. CMS utilizes risk scores for benchmarking purposes.

  • Identify missed coding opportunities and develop strategies for follow up.
  • Identify beneficiaries with rising risk scores who may be appropriate for a (chronic care management) CCM program.
  • Measure impact of interventions/follow up efforts.
  • Determine which intervention strategy is appropriate for each TIN.