Services
AREAS OF EXPERTISE
- Review operations end-to-end, measuring operational and financial metrics and looking for opportunities for improvement.
- Review data processing, including claims/encounters, pharmacy, medical chart review, annual wellness visits, and data submission and acceptance by regulatory agencies.
- Review of data quality, quantity, and robustness.
- Coding operations (internal or external).
- Review of risk adjustment HCC profiling with each new model.
- Forecasting risk adjustment score and revenue to provide insight into final payments.
- Review of analytics enabling tools for risk adjustment and other side adjacent operations.
- Review of incentive structures, including physician incentives, vendor incentives, and provider group contract incentives. Do they provide the return you need?
- Help determine what type of contracting is best given the capabilities of payers and contracted providers.
- Review of current contracts and how metrics are implemented.
- Review of provider group delivery systems and performance.
- Review the integration of risk adjustment operations and analytics to monitor contract performance metrics. Risk adjustment helps to level the playing field in value-based care by ensuring that providers are evaluated and fairly compensated based on the complexity of patient populations. This promotes better care for all patients and helps to drive the overall goals of value-based care.
- Review report deliverables to and from provider groups with VBC contracts.
- Utilizing risk adjustment operations and analytics to track quality metrics used by STAR and HEDIS . Risk adjustment is not just about revenue; it’s a critical tool for ensuring the accuracy and fairness of quality measurement in healthcare. Risk adjustment enables a more nuanced understanding of provider performance by accounting for patient complexity and other factors. It promotes a focus on delivering high-quality, equitable care to all patients and still providing better financial results.
- Integration of the development of chart retrieval targets reduces duplication of effort and provider abrasion. This often leads to cost savings for your chart review programs of approximately 25%.
- Review of deliverables, dashboards, and reports to provide more transparency and easier tracking of progress towards quality measures for payers and providers.
- We don’t just want to provide a singular-point solution. improvements in specific and siloed operational areas work for a while. But as these operations mature, they become increasingly disconnected from other operations that leaders normally would expect some coherence.
- Developing Risk Adjustment, Quality, and VBC operations can yield enormous benefits. However, to fully realize the value of your investment in the analytics behind these operations, they need to be tightly integrated with other areas of operations like pharmacy, contacting, actuarial services, and care management.
- We can help leverage your analytics-focused departments, like Risk Adjustment, to enable other functional areas that can use this expertise and tools to enhance their operations with improved efficiency and better insight to achieve their goals.
With 16+ years of experience, the team has a leader in digital design and innovations
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Andrew Symonds
CEO
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nunc vulputate libero et velit interdum, ac aliquet odio mattis. Class aptent taciti sociosqu ad litora torquent per conubia nostra, per inceptos himenaeos. Curabitur tempus urna at turpis condimentum lobortis.
Andrew Symonds
CEO
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Nunc vulputate libero et velit interdum, ac aliquet odio mattis. Class aptent taciti sociosqu ad litora torquent per conubia nostra, per inceptos himenaeos. Curabitur tempus urna at turpis condimentum lobortis.
Andrew Symonds
CEO
Get in Touch with Us, We are available 24/7
We’re here to help you achieve your healthcare goals. Reach out to discuss your challenges, explore solutions, or schedule a consultation.
- 1-562-578-1583
- info@liveloophealth.com
- Colorado Springs, CO
