Author: jackcolin

Prospective risk adjustment changes how clinicians manage patient care by providing critical insights during visits. It identifies undiagnosed conditions, care gaps, and supports clinical decision-making in real time. Traditional risk adjustment often misses conditions until retrospective reviews are conducted. Prospective systems analyze documentation in real time, flag potential diagnoses, and alert providers during the visit for timely intervention. What Makes Prospective Risk Adjustment Different? Prospective risk adjustment identifies patient risks during clinical encounters rather than retrospectively. It analyzes physician notes in real time, extracts relevant clinical data, and highlights coding opportunities during the visit. Core capabilities include: Documentation becomes a…

Clinicians often face challenges with traditional MIPS reporting, including navigating hundreds of measures, manually entering data, and reporting metrics that may not reflect actual patient care. Instead of selecting from dozens of unrelated quality measures, MIPS Value Pathways (MVPs) allow clinicians to report measures that are relevant to their specialty. Cardiologists focus on cardiovascular outcomes, orthopedic surgeons track surgical quality measures, and primary care physicians monitor preventive care indicators. This targeted approach reduces reporting time, eases administrative burden, and connects quality measures with cost and improvement activities. What Are MIPS Value Pathways? MIPS Value Pathways (MVPs) are specialty-based reporting models…