Podcast: Health Care Trends – In-Home Assessments

When quality teams and risk teams operate in isolated silos, Medicare Advantage plans miss vital opportunities to improve member outcomes and boost Star Ratings. For years, health plans have treated clinic-based Medicare Annual Wellness Visits (AWVs) and vendor-deployed In-Home Assessments (IHAs) as completely separate initiatives. AWVs focus on…

Risk Adjustment Data Validation (RADV) audits present a significant operational challenge for risk-bearing organizations. When CMS audits your medical records, unverified diagnosis codes can quickly lead to substantial compliance penalties and payment adjustments. Effective preparation isn’t about scrambling during audit season; it’s about establishing a continuous, clinician-led workflow…

Matrix combines rigorous clinical documentation, coding oversight, independent auditing and closed-loop Care Activation to give health plans greater confidence that in-home assessment findings are accurate, defensible and actionable. Independent Validation at Scale Matrix engages an independent external vendor to audit a monthly sample of Comprehensive Health Assessments (CHAs)…