Not a coding problem.
A system design problem.
Fix the system → accuracy follows.
#HealthTech #RiskAdjustment #HCC
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Hashtag
#riskadjustment
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Diagram comparing longitudinal vs encounter-level comorbidity detection using ICD-10 codes across five patient encounters. Top panel (Longitudinal): The patient initially has uncomplicated diabetes (E11.9). Later an encounter includes E11.22 and K72.10, indicating complex diabetes and severe liver disease. Using longitudinal logic, these conditions persist in later encounters even when only E11.9 appears, preserving severity and correctly flagging severe liver disease. Bottom panel (Encounter-level): Each encounter is evaluated independently. Diabetes changes from uncomplicated → complex → back to uncomplicated when E11.9 reappears, and severe liver disease is never flagged because its code does not repeat. Message: Ignoring patient history can downgrade severity or fail to identify comorbidities.
Graphic showing how the medicalcoder R package controls comorbidity detection using the flag.method argument. Left side: A sample dataset of patient encounters with variables patid, encid, icd10code, and poa, containing ICD-10 codes such as E11.9, K72.10, and E11.22. Below the dataset are two example R code blocks calling medicalcoder::comorbidities(): flag.method = "current" (default), producing encounter-level comorbidity flags. flag.method = "cumulative", producing patient-level flags that preserve comorbidities across encounters. Right side: the medicalcoder hex logo and labels explaining that current = encounter-level and cumulative = longitudinal history preserving. The graphic illustrates that longitudinal comorbidity tracking in medicalcoder is controlled by a single argument.
Same ICD codes. Same patient. Different risk profiles.
Encounter-level comorbidity logic assumes ICD codes are re-reported every visit. They usually aren’t.
medicalcoder handles this
📦install.packages("medicalcoder")
#rstats #HealthInformatics #EHR #ClinicalResearch #RiskAdjustment #PublicHealth
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Curitics helped align infrastructure to momentum:
- AI-driven risk identification
- Automated workflows
- Unified data foundation
- Low-code adaptability
- Real-time ops visibility
Growth is only sustainable when operations scale with it.
#MedicareAdvantage #HealthcareOperations #RiskAdjustment
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At Curitics Health, we focus on embedding risk adjustment intelligence directly into care workflows supporting clinicians without adding administrative burden.
#RiskAdjustment #HCC #CodingAccuracy #MedicareAdvantage #ValueBasedCare #HealthcareOperations
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The future of risk adjustment is AI-driven.
By connecting fragmented data across labs, pharmacies, primary care, hospitals & post-acute settings and applying machine learning + generative AI - organizations can generate meaningful diagnostic inferences in real time.
#RiskAdjustment #ValueBasedCare
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What adjustments is your organization making right now?
#RiskAdjustment #MedicareAdvantage #HealthcareOperations #ValueBasedCare #HealthcareData
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Risk Adjustment Version 28 is more than a model change.
In this video, Unmesh Srivastava, CEO at Incuvio Health, shares why V28 shifts risk adjustment away from claims and toward real-time provider documentation and compliant coding at the point of care.
#RiskAdjustment #V28 #HCCCoding #RAF
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Not a critique, just a useful reminder that incentives and measurement design matter as much as interventions.
buff.ly/1NNwfDW
#ValueBasedCare #HealthAnalytics #RiskAdjustment #ProviderFinance #HealthcarePolicy
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HCC accuracy doesn’t come from more tools.
It comes from better workflows.
Prebuilt HCC coding workflows from Curitics Health connect documentation, detection, review, validation, and submission—without breaking clinical flow.
#HealthTech #RiskAdjustment #HCCCoding #ValueBasedCare
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Regulatory change isn’t slowing down.
The transition from V24 → V28 has made risk adjustment a moving maze.
At Incuvio, RAF Intelligence adapts in real time:
• Supports V24, V28 & blended models
• Automatically adjusts to policy changes
incuvio.com/incucio-raf-...
#RiskAdjustment #HealthTech #V28
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We strongly recommend evaluating your data. The upcoming RADV storm will undoubtedly uncover common errors.
Being audit ready is paramount.
We offer a free consult with new clients including RADV strategies.
refinica.com/contact-us/
#RADV, #riskadjustment, #populationhealth, #populationhealth
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CMS models won’t stop evolving - V24, V28, blended approaches are now the norm.
Adaptive RAF technology ensures risk models adjust automatically as regulations shift reducing lag, rework, and uncertainty.
#RiskAdjustment #HealthcareAnalytics #ValueBasedCare #HealthTech
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Regulations shift. Is your risk adjustment process keeping up?
With CMS model changes like V28, outdated RAF scoring means gaps in accuracy and compliance.
That’s why we built Incuvio RAF Intelligence:
incuvio.com/incucio-raf-...
#HealthTech #RiskAdjustment #CMSV28 #AIinHealthcare
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Modern clinical operations should be connected and predictable.
This is the new standard.
Book Demo: curiticshealth.com/demo
#CareManagement #RiskAdjustment #HealthTech #CuriticsHealth
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What strategies are your organizations using to implement this targeted, high-touch approach?
#ValueBasedCare #RiskAdjustment #PrimaryCare #FinancialOptimization #HealthTech
buff.ly/Ya2RED9
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Recently, Dr. Shannon Decker joined me on the Agent Survival Guide Podcast to talk about risk adjustment, the switch from V24 to V28 coding, and what other recent changes mean for value-based care. lnk.to/ASGDecker
#RiskAdjustment #ValueBasedCare #RAFScore #CMSUpdates #V28Model
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Identifying risk adjustment gaps shouldn’t feel like solving a puzzle with missing pieces.
At Curitics, we’re using AI + smarter analytics to make risk adjustment simpler, faster, and more accurate.
Book demo: curiticshealth.com/demo
#HealthTech #RiskAdjustment #ValueBasedCare
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Ignoring the nuances of HCC documentation means leaving potential savings on the table and misrepresenting your patient acuity. It's a foundational element for success in a downside risk environment.
#TEAMModel #RiskAdjustment #ValueBasedCare #BundledPayments #HospitalStrategy #HealthcareFinance
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We used the 2014 to 2023 #RiskAdjustment summary reports for the individual market for the thirty two states that had consistently used Healthcare.gov in the study period as well plus NJ, NM, NV & PA
We excluded ME for merge markets
and KY for multiple switches
2/7
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Want to see how it works?
Book a demo: curiticshealth.com/demo
#RiskAdjustment #ValueBasedCare #HealthPlans #CuriticsHealth
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If “lack of scalable technology” is holding your coding team back, it’s time to explore a better way.
🔗 Book a demo: curiticshealth.com/demo
#RiskAdjustment #HCCCoding #ValueBasedCare #CuriticsHealth
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How are you leveraging advanced analytics to transform your VBC initiatives and proactively manage patient outcomes?
#ValueBasedCare #HealthcareAnalytics #PredictiveModeling #RiskAdjustment #DataScience #PopulationHealth #HealthTech
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We’re headed to Las Vegas!
From Aug 25–27, Curitics Health will be at RISE West 2025, and Danielle Meldru will be there representing our team.
Let’s talk value-based care, risk adjustment, and how we’re making care management seamless.
#RISEWest2025 #ValueBasedCare #RiskAdjustment #Healthcare
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Adjusting #RiskAdjustment in #Alabama should produce detectable impacts in the #ACA individual health insurance market on #networks and #PriorAuthorization
balloon-juice.com/2025/08/08/r...
I'm curious if anyone is attacking this problem?
#HealthPolicy
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21 days to go!
Thrilled to share that Danielle Meldru, COO of Curitics Health, will be at RISE West 2025 in Las Vegas, August 25–27!
If you’re attending, let’s connect in Vegas!
#RISEWest2025 #MedicareAdvantage #ValueBasedCare #HealthcareLeadership #RiskAdjustment #RISEWEST #Healthcare
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At Curitics Health, that’s what we’re building -
Tech that finally aligns payers & providers, so everyone’s working toward better care + better outcomes.
#RiskAdjustment #ValueBasedCare #Interoperability #HCCCoding #HealthTech #CuriticsHealth
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Better documentation = fairer reimbursement.
Let’s stop leaving money on the table.
📅 Book a quick demo: curiticshealth.com/demo
#valuebasedcare #riskadjustment #healthtech #clinicaldocumentation #curitics
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CMS recently published an interesting appendix on #RiskAdjustment for 2024 (and also 2017-2018-2019) where they count the # of people with at least one HCC by state and market category (Appendix H June 30, 2025)
www.cms.gov/marketplace/...
#HealthPolicy #ACA
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You can’t fix what you can’t find.
It’s time to stop chasing charts—and start supporting coders with systems that work for them.
#RiskAdjustment #RetrospectiveReview #HCCCoding #CareManagement #HealthIT #CuriticsHealth
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Risk adjustment shouldn’t be a clean-up job.
It should be a care-enabler.
When risk insights are real-time, everything changes.
#RiskAdjustment #ValueBasedCare #HealthIT #DigitalHealth #CuriticsHealth
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