DENVER – February 23, 2006 – Altitude Edge Consultants has introduced a new service for heath care organizations to help manage changing Medicare payment methodologies. Specifically, this service will help Programs of All-Inclusive Care for the Elderly (called PACE) and other Medicare managed care organizations to understand how these changes impact the organizations and how to develop processes to ensure accurate reimbursement.

“As Medicare moves to 100% Risk Adjusted rates in the near future, it is essential PACE and Medicare Advantage-Special Needs Plans understand the impact risk adjustment has on revenues,” said David Reyes, co-founder of Altitude Edge Consultants. “Our goal is to help organizations understand Medicare Risk Adjustment and adapt appropriately through analysis, planning and organizational alignment. If organizations do not respond optimally to these important changes in Medicare, it could be devastating to the bottom line.”

Under risk adjustment, Medicare has reconfigured how it pays for patient coverage in its managed care products. On January 1, 2004, Medicare phased in the first of several—four for Medicare advantage plans, five for PACE plans—annual increments of risk adjustments, replacing standardized rates. This approach intends to pay health plans that care for ailing beneficiaries more appropriate rates, a benefit to organizations that typically handle seniors with chronic health conditions. To manage the change in Medicare Risk Adjustment, Altitude Edge advises clients that both information systems and processes, and clinical staff who are trained to understand the changes are essential.

“Failure to assess and adjust optimally to Medicare Risk Adjustment will result in underpayments that could cause significant fiscal problems for the organization,” said Reyes. “This may be the single most strategic issue facing PACE organizations today,” he added.

Altitude Edge will offer the following Risk Adjustment services to organizations coping with these changes to Medicare, which will continue through 2008 for PACE, 2007 for others:

• Analyze the organization’s Medicare Risk Adjustment process
• Develop a strengths and weaknesses’ analysis for the organization on Risk Adjustment
• Propose specific Risk Adjustment strategies and methodologies
• Assist with Risk Adjustment process changes.

Altitude Edge Consultants

Altitude Edge Consultants is a unique firm that approaches the future of health care by combining solid strategic analysis and traditional tactics with ideas that help organizations’ reach their peak performance. Altitude Edge helps forward-thinking organizations that support seniors with housing or health care services, including PACE, adult day health centers, retirement communities, assisted or independent living operators, transportation providers and others.

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For Immediate Release: February 23, 2006
Contact: David Reyes, 303-748-6762