As we highlighted, deferred care has increased sizably during the COVID-19 pandemic, making it more difficult for health plans to document their members’ disease burden and coordinate care.

Read our fact sheet to learn how Cotiviti’s Prospective Risk Adjustment solutions address this challenge by providing health plans with the necessary insights to close gaps in care and enable proactive interventions.

Key benefits include:

• Adding an incremental value of $1,400 on average per member annually
• Helping ensure appropriate risk-adjusted payments with accurate documentation and coding of member conditions
• Achieving ROI of 4–7x based on an increased risk adjustment factor from supported diagnoses that map to new and higher value HCCs

Product spotlight: Prospective Risk Adjustment

A growing number of strategic payer initiatives, such as value-based care, intersect both risk adjustment and quality improvement programs. Watch our on-demand panel discussion featuring Cotiviti and PopHealthCare as we discuss how new trends in telehealth utilization, in-home assessments, and Star Ratings can influence both risk and quality programs-—and how this impacts health plans as they set future strategies.