Estimate Medicare Advantage HCC CaptureESTIMATE BASELINE ANNUAL REIMBURSEMENTUnderstanding your opportunity starts with your population size and payment structure. Start by estimating your total Medicare Advantage population size, average payment PMPM, and average RAF score.
$10,800 is calculated from a starting $900 Average Payment Per Member Per Month, multiplied by 12 months to arrive at an $10,800 average payment Per Member Per Year.
ESTIMATE IMPACT OF CDI IMPROVEMENTSYour CDI team focuses on improving documentation for a subset of your population. Adjust the population percentage and RAF improvement to see the estimated impact on per-member-per-year reimbursement.
+$1,620 is calculated from the baseline payment of $10,800 PMPY multiplied by the 0.15 RAF improvement from CDI efforts on 10% of the population (5,000 patients).
ESTIMATE THE IMPACT OF CLINICAL DATA INTELLIGENCEYour CDI team does great work on the 10% of patients they have capacity to review. But there is massive unrealized reimbursement buried in the other 90%.
+$324 is calculated from the baseline payment of $10,800 PMPY multiplied by the 0.03 RAF improvement from Clinical Data Intelligence efforts on the remaining 90% of the population (45,000 patients) not addressed by CDI improvements.
UNCOVER THE TRUE COMPLEXITY OF YOUR WHOLE POPULATIONKeep your outpatient CDI effort focused on the most critical work. Clinical Data Intelligence reads virtually everything in the patient record, and pairs that understanding with a massive medical knowledge graph.
Ready to see what Clinical Data Intelligence can do for your organization? Let's talk!
Interested in seeing what Clinical Data Intelligence can do for your organization? Let's talk!
