Your HCC Risk Management Personality Test
Assume, for a moment, you run a 20,000 member health plan. There are two options for you to manage HCC-based risk adjustment:
Option 1: you spend $480,000 on retrospective chart review for 2006 dates of service, and recover $6 million ($30 pmpm). Net recovery is $5.52 million
Option 2: you spend $1.2 million on retrospective chart review for 2006 dates of service, and recover $15 million ($63 pmpm). Net recovery is $13.80 million.
Which do you pick: cost or net recovery?
Your answer says a lot about which HCC management outsourcing solution you will be most comfortable with.
Option 1: you spend $480,000 on retrospective chart review for 2006 dates of service, and recover $6 million ($30 pmpm). Net recovery is $5.52 million
Option 2: you spend $1.2 million on retrospective chart review for 2006 dates of service, and recover $15 million ($63 pmpm). Net recovery is $13.80 million.
Which do you pick: cost or net recovery?
Your answer says a lot about which HCC management outsourcing solution you will be most comfortable with.
posted by Leprechaun Staff at 8:45 PM
1 Comments:
Definitely greater investment for greater return. In the healthcare environment today, now is the time to be bold and take risks and turn the corner. As an Adjunct Professor for a Masters in Health Care Admin, it would be helpful to know more about pricing.
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