Case Study: How Village Family Practice Tackled Risk Adjustment to Code for Care

Author:
Dean Stephens
Date:
October 6, 2016

In a new case study, we detail how Village Family Practice, a Houston-based multi-specialty practice with 45 providers across seven locations, implemented our analytics-driven Coding InSight solution to tackle the challenges of risk adjustment and risk-based contracting.

It’s no secret that value-based care is quickly becoming the industry mainstay. Leading this shift are the Centers for Medicare & Medicaid Services (CMS) and commercial payer organizations who are increasingly using risk adjustment as a key mechanism for predicting patient health costs and adjusting reimbursement rates accordingly.

Yet without the proper tools, accurate risk-adjusted coding can be a serious challenge for providers who are participating in risk-based contracts. Missed codes and coding gaps negatively affect care quality and patient outcomes. They can also lead to inaccurate risk scores and incorrect reimbursements.

Like many providers across the country, Village Family Practice was relying on manual, labor-intensive and error-prone coding practices that were taking the clinicians’ valuable time away from their patients. They came to Talix looking for an automated solution to the many challenges associated with risk-based contracting — improving coding efficiency, risk score accuracy, care planning, and overall patient outcomes.

After implementing our Coding InSight solution, Village Family Practice realized a 15-20 percent improvement in RAF score accuracy and $3.5 million in annual revenue impact. They also earned national recognition from Health Data Management as the “Analytics All-Star: Project of the Year” for using advanced technologies to more effectively and efficiently manage risk.

Watch their story here:

You can also download the full case study at http://www.talix.com/vfp-case-study/.

For more information on how Talix and Coding InSight can help you solve your risk adjustment challengescontact us at info@talix.com.

Dean Stephens is the CEO of Talix.
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