Tag: Episource

Effective Digital Transformation In Healthcare: 4 Key Characteristics To Look For In a Risk Adjustment Partner

Vinitha Ramnathan

By Vinitha Ramnathan, senior vice president of product management, Episource.

Digital transformation is responsible for a lot of very promising innovations in healthcare. From telemedicine to AI-enabled medical devices to NLP-driven coding, technology is reshaping how patients interact with providers, how data is shared, how care decisions are made, and how population risk is managed.

But implementing new technology can be a tall order for such a complex and overburdened industry. Perhaps this is why only 7% of healthcare and pharma organizations surveyed said they had “gone digital.” As more healthcare organizations move into value-based care, embracing a digital mindset will be critical to meeting the ever-changing needs of patients — and that starts with data.

The Importance of Data

Like in any industry, health plans require large amounts of data to improve performance over time. However, data is only as valuable as the information that can be gleaned from it. Due to the explosion of healthcare data, it can be difficult for plans to put this valuable information to work. COVID-19 has exacerbated this problem, increasing telehealth visits 38 times over pre-pandemic levels. This trend is predicted to continue, as experts project that $265 billion in Medicare fee-for-service and Medicare Advantage care services will be done at home by 2025.

Partnering with a risk adjustment vendor can help health plans and risk-bearing providers see beyond the data weeds. Partnering with multiple vendors, however, can actually contribute to the problem, leading to siloes, disjointed workflows, and reduced visibility into key metrics.

To solve this, a growing number of healthcare leaders are streamlining workflows and replacing individual solutions from multiple vendors with a single, integrated tech stack. This platform approach can result in more accurate risk scores, reduced provider abrasion, and improved patient care. To help health plans do just that, we’ve outlined four key attributes to look for in a risk adjustment partner.

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