MAGENTA CARE CONTINUUM RELEASES SUSPECT DELETE TECHNOLOGY TO REDUCE AUDIT RISK FOR MEDICARE ADVANTAGE PLANS
DENVER, March 23, 2023 /PRNewswire/ -- Magenta Care Continuum has announced the launch of a new technology that will support Medicare Advantage (MA) plans in their audit risk mitigation strategy. The new suspect delete technology works exclusively from claims data, combining machine learning, clinically derived heuristics, and over 50,000 predictive rules to identify unsupported Hierarchical Conditions Codes (HCCs) at risk for HHS RADV and Medicare RADV audits.
This is particularly important as the Centers for Medicare and Medicaid Services (CMS) published a Risk Adjustment Data Validation (RADV) Final Rule earlier this year to recover improper risk adjustment payments. According to Fierce Healthcare, this will have a potential $5 billion impact on Medicare Advantage plans over the next decade. Magenta believes the lack of automation and room for manual error is contributing to this challenge.
Beta tests have demonstrated over 90% accuracy with Magenta's suspect delete technology, covering all Hierarchical Condition Codes (HCCs), especially codes prioritized in OIG audits. The analytics engine is extremely fast and can run millions of member histories in just a few hours. The output includes specific member HCC assignments, error rates by provider, by provider group, and by plan, segmented by HCC on both frequency and RAF basis.
Magenta is offering a one-time analysis for the next 3 months at an introductory price of 10 cents per member to report unsupported HCCs back to MA plans so that they can take the appropriate action. Magenta's suspect delete technology is a vital tool for Medicare Advantage plans looking to mitigate their audit risk and ensure proper risk adjustment payments. Reach out to [email protected] to learn more.
About Magenta Care Continuum
Magenta Care Continuum is a leading digital health analytics company that specializes in supporting value-based care organizations, including Medicare Advantage and ACA plans. Magenta's risk adjustment analytics suite enables organizations to assess and identify care gaps in their member population through the use of transparent, actionable AI. Magenta has received funding from top venture capital firms, including GV (formerly Google Ventures), Olive Ventures, FirstMile Ventures, and TFX Capital.
About Magenta's Founder and CEO
Rick Adam is a highly successful serial digital health entrepreneur and the founder and CEO of Magenta Care Continuum. Prior to founding Magenta, Rick led Empiric Health, an analytics company spun out by Intermountain Healthcare. He has also served as CEO for Stanson Health, Recondo Technology, and New Era of Networks (NEON).
Before his career in digital health, Rick was a Partner at Goldman Sachs, where he led the IT and securities processing teams. He also has an extensive background in the military, having served in the Air Force as a launch crew officer. During the period of Apollo missions 8 through 14, he ran the Real Time Computer Centers at both the Kennedy Space Center and Vandenberg Air Force Base.
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SOURCE Magenta Care Continuum
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