Category: Risk Adjustment

Stay up-to-date on the latest healthcare risk adjustment & technology perspectives.
Risk Adjustment

A Holistic Approach to Help Providers Transition to Value-Based Care

CMS is expecting 100% of providers to accept downside risk by 2025. Three key opportunities for organizations to assist providers in the transition to value-based care delivery.

Risk Adjustment

Beyond the Data Weeds: Analytics for Stronger Performance Across the Risk Adjustment Lifecycle

Master the complexity of Medicaid state-to-state guidelines with three risk adjustment strategies for success.

Risk Adjustment

Advancing Technology and Teams to Serve In-Need Populations with Dignity – Interview

Interview at RISE National with U.S Hunger CEO, Rick Whitted, shares his perspective on learning and advancing technology through the pandemic and how to treat people and teams with dignity and trust.

Risk Adjustment

Leveraging Political Insights to Power First-Class Healthcare – Interview

Interview at RISE National with Meyers Group, LLC Senior Partner, J.R. Meyers, shares his perspective on navigating the political environment to generate funding and access for his clients, particularly hospitals and healthcare organizations.

Risk Adjustment

Intersecting Patient Experience with Data to Change Health Outcomes – Interview

Interview at RISE National with AmeriHealth Caritas risk adjustment leader, Vandna Pandita MPH, shares her perspective on standing out as a female executive of color and championing data integrity to drive better patient outcomes.

Risk Adjustment

Analytics, Audits, and Building a Successful Risk Adjustment Team – Interview

Interview at RISE National with Capital Blue Cross risk adjustment leader, Deborah Conboy, shares her perspective on reducing the risk of RADV audits and why risk adjustment professionals should bolster their in-house analytics capabilities.

Risk Adjustment

Mastering Data Agility and Seamless Integrations with the Right Risk Adjustment Vendor – Interview

Interview at RISE National with CareFirst BlueCross BlueShield risk adjustment leader, Biodun Kajopaiye (BK) MHSA, CRC, sharing his perspective on using healthcare as a platform to deliver value and what to look for in a risk adjustment vendor.

Risk Adjustment

Compliance 101: Everything You Need To Know About Regulatory Audits in 2022

As CMS, OIG, and the DOJ increasingly use data analytics to identify instances of fraud, waste, and abuse, health plans must take steps to address compliance issues before they arise.

Risk Adjustment

3 Tech-Led Retrospective Strategies To Maximize Program Performance Without Provider Abrasion

How can health plans take advantage of the submission deadline extension without putting pressure on already overburdened providers? Read more to find out.

Risk Adjustment

Is 95% Coding Accuracy Good Enough?

Most health plans only code medical records to 95% accuracy, but in today’s challenging landscape of rising costs and growing compliance risk, this is no longer enough.

Risk Adjustment

Using Technology to Reduce the Risk of RADV Audit

With increased audits and crackdowns on inaccurate risk scores, it’s more important than ever to have a comprehensive coding review process in place.

Risk Adjustment

The Best of Both Worlds: Balancing Retrospective & Prospective Strategies

To navigate the transition to value-based care, healthcare organizations need to integrate both prospective and retrospective strategies into their risk-adjustment programs.

More posts


We simplify the management of member programs by making it radically more efficient, and increasing value to healthcare organizations and their members

Presentation @ RISE VBC: Effective Collaboration Strategies Between Payer & Provider