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Driving accurate risk adjustment through smarter workflows, better documentation and empowered care teams

Product details

Validates risk adjustment by capturing and sequencing conditions to accurately reflect expected rates of mortality, readmissions and complications
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Optimizes processes that impact risk adjustment, improving concurrent and discharge workflows as well as documentation practices
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Empowers teams with education and training to sustain quality improvements and maintain compliance across major risk adjustment methodologies
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The challenge: Accurately reflecting quality in a complex landscape

Hospitals and health systems face scrutiny from public and private profiling organizations, such as Healthgrades, U.S. News & World Report, LeapFrog, Vizient and Premier. These organizations report quality measures like mortality, readmission and complication rates, which can impact external rankings and reputation. Thus, hospitals and health systems must ensure their risk profile and outcomes are accurately represented.

To improve these quality measures and thrive in today’s value-based environment, healthcare organizations can implement quality initiatives, but it can be difficult to determine which of these initiatives will be most impactful. Finally, issues like incomplete documentation capture and sequencing of risk-adjusted conditions, suboptimal coding and workflow gaps can result in a poor reflection of true quality, affecting both public scorecards and reimbursement.

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The solution: Comprehensive risk adjustment through a quality lens

Solventum Risk Adjustment and Quality Optimization Services offer a targeted approach to accurately reflect risk of mortality, readmissions and complications. Our experts work collaboratively with your team to:

  • Validate risk adjustment by thoroughly reviewing and confirming documentation and code capture, as well as properly sequencing the top 25 most impactful codes
  • Assess and redesign key workflows, including admit source, admit type, discharge disposition review and mismatch reconciliation
  • Optimize both risk adjustment and quality reporting processes to streamline quality initiative approach

In addition, tailored education and training are delivered to providers, clinical documentation integrity (CDI) professionals, quality and coding teams, deepening their understanding and practical application of risk adjustment methodologies.

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Your partner in driving measurable quality improvements

Solventum consultants offer deep expertise in risk adjustment, coding and workflow optimization, leveraging public and proprietary metrics to identify and address root causes of quality issues. We deliver organization-specific implementation plans tailored to your unique challenges and goals. Our approach helps drive measurable improvements in quality metrics, public rankings and reimbursement, while reducing initiative fatigue and supporting sustainable change.

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