Risk Adjustment

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Many organizations provide quality rankings for physicians and hospital systems—determined after risk adjustment is applied. Risk adjustment is based on clinician documentation. Only coded diagnoses are included in the risk adjustment. ICD-10 specific documentation is paramount to demonstrating quality!

Risk adjustment methodologies:

  • APR-DRG system
  • MS-DRG system
  • HCC system

QUALITY: Organizations use risk adjustment to determine quality ratings.

Download the complete tip, Risk Adjustment.