Risk Adjustment and Social Determinants of Health in Medicare Advantage and Medicaid

Risk Adjustment and Social Determinants of Health in Medicare Advantage and Medicaid

Revenue cycle leaders face increasing pressure to manage costs, optimize revenue, and improve revenue cycle functions. This has included more responsibility in understanding the intersection between risk adjustment coding and social determinants of health (SDOH). This intersection is critical to ensuring accurate reimbursement and optimizing revenue cycle outcomes, especially for Medicare Advantage and Medicaid populations, where SDOH significantly influences health outcomes and

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