BC Advantage - 2025 Issue 5

Handling Risk Adjustment and HCC Coding in Value-Based Care

Value-based care (VBC) advocates for a healthcare delivery model that shifts from a volume-based approach to one that aims to align healthcare outcomes with payments for services tied directly to the quality of care provided and patient outcomes achieved. This model encourages healthcare providers to focus on delivering high-quality care to patients while optimizing healthcare resources.   Financial incentives seek to streamline costs to make high-quality care more accessible and affordable while creating a more efficient, patient-centric healthcare system. The Affordable Care Act (ACA) and the transition to electronic medical records (EMRs) acted as catalysts, with the introduction of...

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