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Lab Data Crucial to Insurer Risk Adjustment Models

With Medicare Advantage payers, clinical labs can be paid for adding value

CEO SUMMARY: Payers who use risk adjustment models as part of Medicare Advantage need diagnostic data that helps them document ICD-10 diagnoses that earn them higher premium payments for sicker patients. Clinical labs have lab test data that can identify undiagnosed disease and share in the higher risk-adjusted payments. IN TRANSITIONING FROM FEE-FOR-SERVICE MODELS TO …

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