Issue link: https://insights.evolent.com/i/1405289
EHS-2012094-0820 Prospective Risk Adjustment: Powerful Insights Integrated into Preferred Provider Workflow • Industry-leading machine learning analytics that eliminate noise and surface relevant diagnoses before the patient visit • Development of custom incentive programs to increase provider engagement • Seamless multi-modal workflows including direct EMR integration • Integrated view on quality focusing on panel and patient insights for open gaps in care • Local and national operational support POWERFUL CAPABILITIES TO DRIVE IMPROVED FINANCIAL AND CLINICAL OUTCOMES For years, many health care organizations have struggled to implement a successful risk adjustment program. There are numerous reasons for this, including an inability to get provider buy in, limited actionable data, as well as a reliance on retrospective initiatives. Health plans need a strategic partner with a deep provider heritage and a comprehensive set of capabilities to deliver a holistic solution that will result in improved provider relations, enhanced clinical outcomes, and more accurate results. PROSPECTIVE-LED APPROACH TO RISK ADJUSTMENT Evolent Health Services delivers a comprehensive risk adjustment solution that is anchored through an intense focus on successful provider engagement. We collaborate with our partners to develop and implement strategic incentive programs that emphasizes a focus on quality of care and patient outcomes. Leveraging machine learning and a robust set of tools, we can embed clinically appropriate diagnoses directly into the workflow and enable providers to document accurately at the point of care. This provider-oriented approach drives increased documentation of inferred conditions and reduces the administrative burden tied to retrospective chart retrieval and review. In addition, this prospective-first strategy also brings multiple clinical benefits, including deeper integration between risk adjustment and quality initiatives, better alignment with care management, and a boost in provider sentiment that risk adjustment is a clinically relevant, member-centered activity rather than a purely financial exercise. OUR CAPABILITIES Provider-Oriented Risk Adjustment Solution Retrospective Risk Adjustment: Ensuring Coding Accuracy and Completeness • Multifaceted chart retrieval approach • Chart prioritization and efficient usage of coders driven by natural language processing technologies • HIPAA-compliant workflow tools designed to support coding accuracy • Comprehensive encounter submission capabilities evolenthealthservices.com