News: Risk-based population health revenue on the rise

CDI Strategies - Volume 11, Issue 50

More of healthcare organizations net revenue relates to risk-based population health management activities, according to HealthLeaders Media’s 2017 HealthLeaders Media Population Health Survey.

Likely due to the need for sufficient financial resources to support a population health program, a greater share of health systems (65%) than hospitals (45%), and physician organizations (34%) are fully committed to risk-based reimbursement and have programs underway. Additionally, based on net patient revenue, a greater share of large organizations (74%) than medium (50%) and small organizations (44%) are fully committed and underway.

Overall, shared savings programs with payers (48%) and bundled payments (47%) are the top two financial risk structures by a large margin, with direct contracting with employers (28%) rounding out the top three.

Because of the growing embrace of risk-based population health, as evidenced by the HealthLeaders survey, CDI professionals will increasingly be called upon to understand and use risk-adjustment methodologies and more and more programs have begun to expand their review focus to quality of care measure capture and outpatient services.

Editor’s note: To read HealthLeaders Media’s coverage of their survey results, click here. To watch the 2016 CDI Week webinar focused on risk adjustment, click here. To learn more about ACDIS risk adjustment and coding boot camp, click here.