Accuracy Matters

So much of healthcare performance comes down to one simple truth:

Your clinical data is only as accurate as the specificity behind it.

Across Medicare Advantage, ACOs, Medicaid Managed Care, and Commercial Exchange plans, risk adjustment is a core driver of reimbursement, resource allocation, and care strategy.

And in every one of these models, accurate patient risk scores depend on the level of specificity in documentation and coding.

Every day, diagnoses flow into EMRs through data exchange, shared records, consult notes, hospital discharges, and internal documentation.

On the surface, it looks like a complete clinical picture.

But here’s what we see again and again:

-  Conditions are present, but documented too broadly

-  Diagnoses are exchanged, but not validated

-  Codes are technically correct, but not specific enough

-  Health complexity is real, but not reflected in the risk score

And when specificity is missing, the entire system feels it:

-  Risk scores underrepresent true illness burden

-  Clinical teams coordinate care with incomplete information

-  Organizations are underpaid for the complexity they manage

-  Audit exposure increases due to weak documentation

-  Population health strategies lose accuracy

Specificity isn’t a coding preference, it’s the foundation of documentation compliance, clinical clarity, financial integrity, and patient-centered care. When coders and clinicians work together to refine diagnostic coding to the right level of specificity, organizations see immediate impact:

-  RAF scores that reflect real patient complexity

-  Better resource allocation and care coordination

-  Stronger audit resilience

-  More accurate value-based payments

-  Financial performance that mirrors clinical effort

If your EMR looks full but your outcomes, risk scores, or revenue don’t match the complexity you know your patients carry…

You don’t have a data problem.

You have a specificity problem.

And that’s exactly where RVA Healthcare Consulting can help.

Schedule a free 30-minute consultation with RVA to ensure your documentation, coding, and risk accuracy truly reflect the patients you serve.