1 Healthcare Solutions Data Sheet Nuance Quality and Risk Adjustment Improve care quality and risk adjustment at the point of decision making. Patient-focused, just-in-time intervention management engages providers. Healthcare organizations face a compelling combination of challenges: providing comprehensive care and disease management across the Help providers improve continuum of care while maintaining financial viability in a dynamic, documentation quality without value-based environment. And with the new care and payment models compromising patient care supported by Medicare Advantage plans, Accountable Care Organizations, Integrates seamlessly with your – and others, providers shoulder more accountability and financial risk today. electronic health record (EHR) so physicians can focus on patients With a shift toward outpatient care, effective population health management and not the technology strategies become even more essential to your success, but many providers Helps ensure providers document – lack the resources to proactively identify and assess high-risk patients as requirements for HCC coding and well as the ability to improve the quality of clinical documentation. achieve accurate RAF scores Ensures no conditions are missed – Optimizing patient outcomes amid a changing landscape by recapturing suspected HCCs ® The Nuance Quality and Risk Adjustment platform offers patient-focused, Drives better care and appropriate – just-in-time intervention management that enables: reimbursement through complete capture of diagnosis, – Proactive targeting of chronic conditions with high-risk patient scheduling complications, and comorbidities – Efficient presentation of opportunities to providers (CC/MCC) Improved documentation of care – – Automates extraction of diagnosis – Enhanced communication between caregivers codes to save time and ensure the – Improved HCC capture rates right codes make it to the claims— Greater accuracy of Risk Adjustment Factor (RAF) scores – the first time, every time In-workflow intelligence delivers context-aware, personalized clinical guidance at the point of decision making. This approach ultimately leads Experience makes the difference to better planning, treatment, and patient care, as well as appropriate Nuance’s heritage builds on decades reimbursement. of clinical expertise, technology innovation, and experience with - With Nuance Quality and Risk Adjustment, physicians and coders can cap EHR workflows that are designed ture a broader picture of each patient’s chronic conditions, looking beyond to improve provider engagement. the obvious to create a more coordinated, proactive, and compliant practice. We have direct and successful experience in the HCC coding Engaging and supporting your providers environment, including proven with a comprehensive approach strategies for provider change management, compensation, and The journey to value-based care is different for every organization, and leadership planning. requires a strategic partner that can provide enterprise-wide value throughout your journey. Nuance Quality and Risk Adjustment solutions make sense of both structured and unstructured health information and bring that highly curated insight to providers, engaging them in their own workflows.
2 Data Sheet Healthcare Solutions Nuance Quality and Risk Adjustment Automating complex risk adjustment coding processes is enabled A win for patient care: streamlining through machine learning, natural language processing (NLP) technology, risk adjustment coding through sophisticated rules engines, and a rich medical taxonomy. These combine better documentation to help improve documentation quality by identifying inaccurate or missing Uncover missed condition codes – condition codes in patient data, as well as by making evidence-based code and documentation gaps recommendations. In short, clinicians and professional coders can quickly – Engage physicians with in-workflow close coding gaps at the point of care. solutions and actionable clinical guidance Nuance Quality and Risk Adjustment solution features Increase coding accuracy and – efficiency to improve productivity Automated chart Artificial intelligence (AI) drives the proactive by 2-3X review evaluation of patient data, including structured and – Identify high-risk patients and unstructured data and prior claims, evidence of improve care planning and chronic/risk-adjusted conditions, and other quality outcomes improvement opportunities. Improve risk score accuracy – Computer-assisted physician documentation (CAPD) In-workflow by 15-20% advice brings in-workflow clinical guidance to accurately – Ensure more accurate identify and document all relevant conditions at the reimbursements and reduce denials point of care to find suspected HCCs, to add greater specificity, and to search for alternative diagnoses. To learn how Nuance Quality and Extracted codes facilitate charge capture workflow so Risk Adjustment can ease the clinical appropriate codes are included in the claim. documentation burden for your care Analytics Population health and HCC specialists can review teams and improve the accuracy opportunities and launch campaigns to improve and coding of risk adjustment performance, patient outcomes and improve the accuracy of RAF workspace please call 1-877-805-5902 or visit scores, as well as monitor and improve overall program nuance.com/healthcare . performance. Coding teams can also automatically identify and extract diagnosis codes from patient documentation to facilitate charge capture. Process Through training, demonstrations, and coaching, our improvement experienced consultants help your team establish a mutual understanding of the program and implications and education services of value-based care, including Medicare Access and CHIP Reauthorization Act (MACRA) and CMS Star Ratings. We will help facilitate the establishment of a governance/steering committee to help keep your program on track. Change Change management strategies and meaningful incentive programs encourage provider acceptance management and provider and participation to support MACRA and new payment alignment models in alignment with organizational goals. Program health Measure your team’s success in having a positive impact on risk adjustment and quality scores checks and continuing through quarterly performance reviews and ongoing education education. About Nuance Communications, Inc. Nuance Communications, Inc. is a leading provider of voice and language solutions for businesses and consumers around the world. Its technologies, applications and services make the user experience more compelling by transforming the way people interact with devices and systems. Every day, millions of users and thousands of businesses experience or call 1-877-805-5902. Nuance’s proven applications. www.nuance.com/healthcare For more information, visit . and Twitter , What’s next Facebook Connect with us through the healthcare blog, Copyright © 2017 Nuance Communications, Inc. All rights reserved. Nuance and the Nuance logo are trademarks and/or registered trademarks of Nuance Communications, Inc., or its affiliates in the United States and/or other countries. All other brand and product names are trademarks or registered trademarks of their respective companies. HC_4180 SEP 2017
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