Susan Richards is the director of risk adjustment programs and education at Episource. Susan is responsible for developing and managing the integrated programs that support end-to-end retrospective and prospective risk adjustment services, including provider education, HEDIS, and clinical documentation integrity. Nationally recognized as a leader in value-based care, Susan has more than 20 years of leadership experience in the healthcare industry.
To effectively reduce disparities and improve the quality and coordination of care, government, providers, and healthcare organizations are beginning to collaborate on how to best address the factors driving gaps between populations.
Given that providers are under increased pressure from CMS to take on some form of downside risk by 2025, they and health plans can utilize these four strategies to make the transition smoother.
As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers.