Six Best Practices in Risk Adjustment A DST White Paper

Managing risk adjustment payment models has proven to be a challenge for many Medicare Advantage (MA) and Health Insurance Marketplace plans. Some plans have found they lack the resources and expertise needed to ensure risk score accuracy while also complying with US Department of Health and Human Services/Centers for Medicare & Medicaid Services (HHS/CMS) regulations for risk-adjusted payment. To manage these complexities, health plans are implementing new business processes and technology solutions that can help them align premium dollars with member health risk and reduce the risk of legal action under the False Claims Act.

We’re finding that health plans that take a multifaceted approach to risk adjustment reap the greatest benefits. The "Six Best Practices in Risk Adjustment" white paper describes the best practices that many plans are adopting for this critical business process. Complete the following form to download the white paper today.




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