Risk Adjustment

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

Written By
Erik Simonsen
Chief Operating Officer

Navigating health care’s complex risk adjustment compliance landscape can feel akin to playing whack-a-mole. New regulations, evolving audit methodologies, and increased scrutiny are a constantly moving target that pose significant challenges for health plans, which are already under strain as we head into year three of the pandemic. Compounding the issue, available solutions are often piecemeal and lack the analytical rigor to address problems at their root.

To cut through the noise, we’ve broken down everything you need to know about compliance audits in 2022. The overarching theme: Regulatory bodies are increasingly using data analytics to guide their audit processes to great effect. In this landscape, compliance can no longer be an afterthought. Health plans must take proactive steps to address issues before they arise so they may focus their valuable time and resources on what matters most—caring for patients.

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