Baird said the outcomes from the final 2025 healthcare exchange risk adjustment transfers support Centene’s prior Q4 ...

The Alliance of Community Health Plans is calling out risk adjustment scores by larger insurers in Medicare Advantage plans. ACHP, an organization that advocates for smaller health plans, said the ...

Faced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care ...

Health insurers and stakeholders have expressed support for the Centers for Medicare and Medicaid Services' plan to phase in changes to the risk adjustment model over three years, in the 2024 Medicare ...

If finalized, these proposals will generally take effect on January 1, 2025, unless otherwise noted. Both the individual and small group market risk adjustment system are based on a set of regression ...

This is my hands-on evaluation of 10 risk adjustment platforms for value-based care teams preparing for 2026 Medicare Advantage, or MA, and accountable care organization, or ACO, contracts. My scoring ...

The healthcare industry is in the midst of transformational change, driven by the introduction of the V28 Hierarchical Condition Category (HCC) model and other related factors. This change is spurring ...

Risk adjustment could continue to draw on diagnoses from medical claims, but in a more targeted fashion that focuses on diagnoses that supply additional predictive information and are less affected by ...

BELLEVUE, Wash.--(BUSINESS WIRE)--Edifecs, Inc., a global health information technology solutions company, today announced its new product, Concurrent Risk Adjustment (CRA). CRA helps Managed Care ...

Risk Score Model Updates The individual and small group market risk adjustment system relies on a set of regression models that assign risk scores to enrollees based on their plan metal level and ...