Risk Adjustment Accuracy: Chronic Condition Gap Analysis

Client Challenge:

Our client, a Medicare Advantage health plan, wanted to increase the quality of care and improve the accuracy of their risk scores for members with chronic conditions.

Our Solution:

• Cirdan created a report to help the plan identify members with chronic conditions who had not had an annual preventive visit for the year
• The Cirdan report included the chronic condition and the weight of the HCC missing from the current diagnosis information to help the health plan to determine the best course of action to close the care and risk score gaps

The Result:

Cirdan’s report was used by the health plan to close their care gaps in care and ensure the member’s chronic conditions were being managed appropriately.