Solutions / Risk Adjustment & Stratification

Risk Adjustment & Stratification

Risk adjustment and stratification management strategies are critical for organizations involved in value/risk-based care models. The ability to identify high-risk individuals and adjust care plans and payments accordingly helps ensure that resources are allocated effectively, improving care outcomes and optimizing financial performance. Sobah Systems has over 2 decades of experience leveraging data analytics, predictive modeling, and machine learning to accurately stratify patients based on risk factors and health conditions and ensure correct coding for complex patients. The advanced solutions we deploy enable healthcare providers to monitor patient populations, personalize interventions, and ensure compliance with regulatory requirements for risk adjustment.

Healthcare

Common Challenges

  • 1

    Ensuring access to comprehensive and accurate data to make informed risk assessments.

  • 2

    Developing and maintaining sophisticated algorithms that accurately predict patient risk levels.

  • 3

    Integrating risk adjustment tools with existing EHR, claims data and other health IT systems to create a comprehensive patient profile.

  • 4

    Updating systems and processes to comply with regulatory changes and payer requirements related to risk adjustment methodologies.

Our Projects

Value Based Organizations
Home Health / Hospice
Post Acute
Primary & Specialty Care

This case study shows our expertise in systems that improve patient outcomes and support value-based care.

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Our Projects

Revenue Cycle
Value Based Organizations
Primary & Specialty Care
Managed Services

This case study shows our expertise in optimizing medical billing, improving reimbursement, efficiency, and compliance.

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Our Projects

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