Risk and Quality Optimization
Accurate and proactive risk adjustment and quality measure abstraction to optimize revenue and deliver excellent whole-person care
Risk and Quality Optimization
Accurate and timely diagnosis, along with risk and care gap identification and documentation, is critical for success in value-based care. That success is hampered by a lack of staff and resources, gaps in data availability, and the complexities of financial risk.
IKS Health brings together proven technology and expertise to help healthcare enterprises succeed across the spectrum of risk through accurate, proactive risk capture and predictive risk stratification.
Our human and tech solutions act as an extension of our clients’ clinical team, providing richer data at point-of-care. This enables early diagnosis capture and quality of care outcomes, seamlessly preparing clinic staff and clinicians to address risk gaps and create personalized care plans.
Enabling clinicians to identify the right services for whole-person care.
Studies show that early detection can significantly reduce total cost of care while improving the overall quality of life. Precise diagnosis and risk identification provides:
- Actionable clinical and operational insights to support effective care delivery
- Drives quality improvement initiatives
- Enables targeted population health interventions
- Ensures that your organization receives appropriate reimbursement
Resources: Risk and Quality Optimization
Blogs Value-Based Care: A Win-Win for Patients, Clinicians, and Healthcare Organizations
Client Stories Uncovering Previously Undiagnosed Medical Conditions to Improve Patient Care with IKS Health Clinical Chart Review
Client Stories Improved RAF Score and Increased Revenue with IKS Clinical Chart Review
Retrospective HCC Coding: Health Risk and Quality Optimization provides retrospective and concurrent hierarchical condition category (HCC) documentation to accurately represent your panel’s risk.
Retrospective HCC Coding Impact Delivered
Clinical Chart Review: In prospective clinical chart reviews, our trained physicians provide comprehensive reviews across the entire medical record. We go beyond data correlations by using a differential diagnosis process and bi-directional feedback to identify conditions that may have been overlooked.
Clinical Chart Review Impact Delivered
Risk and Quality Optimization Key Benefits
Risk and Quality Compliance
Ensure risk and quality regulatory compliance while freeing up internal resources from cumbersome documentation and review.
Identify Overlooked Chronic Conditions
Trained IKS Health clinicians conduct comprehensive, prospective clinical chart reviews across every corner of the medical record, using a differential diagnosis process to identify overlooked chronic conditions.
Compliant Holistic and Comprehensive Risk and Quality Coding
Concurrent (post-visit) and retrospective (annual) risk coding solutions address HCCs, as well as open risk gaps, to ensure they are coded and submitted.
Less Time Searching for Data
Clinical document management and quality measures abstraction increase data availability in the EHR in the right fields, reducing clinician time to search for data, and increasing the ability to code for gaps addressed outside the organization.
Personalized Action Plan for Clinicians
Personalized clinician engagement with actionable insights at the point of care through inferred diagnosis, recommendations, quality measures, coding gaps, and more.
Risk and Quality Optimization FAQs
IKS Health’s trained physicians, supported by technology, execute comprehensive clinical chart reviews to proactively identify chronic conditions. All identified risk and care gaps are presented to clinicians and clinic staff in their workflow at the point of care.
IKS Health’s Clinical Chart Review is comprehensive, picking up nuances within medical records that clinically support a diagnosis. We review more than data points in a chart, taking into account data that may not be captured in discrete fields. The review complements data correlations and historical conditions to provide a comprehensive diagnostic picture.
IKS Health’s clinical chart reviews are conducted by trained physicians, primarily hospitalists, with deep training on HCCs, to identify missed conditions and provide the right clinical evidence. We also conduct internal quality audits to ensure high quality performance.
Our Value-Based Care solutions are part of the Care Enablement Platform, transforming healthcare delivery through a strategic blend of human expertise and innovative technology.