With 31 reported cases and the CDC saying only about 1 in 5 people who get the virus will actually be sick, hospitals and health departments are working with the CDC and other public health officials to limit Zika from spreading as much as possible.
The average life expectancy for 65-year-olds is projected to rise by almost a year from the 2010 norm, to 20.1 years in 2030. The bad news? Many of those people about to become eligible for Medicare are sick or obese.
Despite all the buzz about population health management, many in the industry are flying blind and will be until they tap the data that enables them to see patients as individuals, rather than sets of common symptoms.
Medicare Advantage (MA) plans are private health plans that have contracted with Medicare to receive a fixed monthly fee in exchange for providing comprehensive healthcare to plan members. In order to provide appropriate care to beneficiaries with varying medical conditions, plans are paid according to the Risk Adjustment Factor (RAF) score of each patient. Insufficient documentation of chronic conditions can be an obstacle to MA reimbursement. However, even when a condition has been properly documented by the provider, it is often not coded and submitted to Medicare. Read this white paper to learn how to take the complexity out of MA reimbursement.