Business > CASE STUDY > C991_Capstone_Summary__.docx C991 Capstone Summary Capstone program: Master of Health L (All)

C991_Capstone_Summary__.docx C991 Capstone Summary Capstone program: Master of Health L

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C991_Capstone_Summary__.docx C991 Capstone Summary Capstone program: Master of Health Leadership 1.Describe the real-world healthcare challenge or need. Healthcare providers are having challenges... in the document and coding chronic diagnoses. For risk adjustment purposes healthcare providers are required to examine patients on an annual basis to document and code any chronic diagnosis at the point of care as per the Center for Medicare and Medicaid Services (CMS, 2020). If medical documentation lacks the specificity needed and accuracy to appoint the appropriate ICD-10 diagnosis code, healthcare providers are confronted with the likelihood of lowered payment in a performance-based payment model. If a chronic diagnosis is not documented yearly, the diagnosis can â€œfall offâ€ and will be incorporated in the HCC calculation, potentially reducing the risk adjustment score. 2.Describe an innovative solution that addresses the challenge or need. Excellent clinical documentation and accurate ICD-10 diagnosis coding can draw a completed medical picture of what is going on with a patient letting the accurate RAF score be calculated for proper payment. Healthcare providers will be able to recognize codes that will be integrated with the EMR utilizing an easy step-through enhanced risk adjustment analytics.Allow for partnership between healthcare plans and healthcare providers to help develop the quality of care at an affordable cost. Develop a structure for transparent, evidence-based conversations about qu. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . .. .. . . . . . . . . . . . . . . . . . .. . . . . [Show More]

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