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Traditional chart-chase processes are becoming increasingly difficult and expensive to sustain. As CMS expands Risk Adjustment Data Validation (RADV) audits, health plans face greater operational demands, financial exposure, and pressure to produce complete, accurate clinical documentation.

A clinical-first approach moves documentation and validation closer to the point of care. By incorporating timely, authenticated clinical data into provider workflows, payers can improve coding accuracy, reduce retrospective chart retrieval, strengthen provider collaboration, and better prepare for ongoing audit scrutiny.

Download this executive recap from Becker’s Healthcare and InterSystems to explore how payer leaders are modernizing risk adjustment and building a reusable clinical data foundation that supports priorities across the enterprise.

What You’ll Learn

The recap examines how health plans can:

• Reduce reliance on costly and labor-intensive retrospective chart chase
• Address growing RADV audit demands and potential extrapolation risk
• Capture more complete and accurate documentation at the point of care
• Incorporate CCDs, ADT feeds, EHR data, and other timely clinical information into risk adjustment workflows
• Improve provider engagement through education, aligned incentives, and embedded workflows