Risk Adjustment
Expert articles and analysis related to risk adjustment.
AI Summary — Last 30 Days
CMS is moving risk adjustment deeper into the operating core of VBC: the CY 2027 Medicare Physician Fee Schedule/MSSP final rule strengthens the Medicare Shared Savings Program while stakeholders continue pressing for benchmark, attribution, and risk-score policies that better support long-term ACO participation and primary care investment (Premier; Modern Healthcare). At the same time, mandatory and specialty models such as CJR-X and the Ambulatory Specialty Model are increasing the importance of accurate case-mix capture, episode-level financial forecasting, and care coordination infrastructure—shifting risk adjustment from a coding/compliance function into a strategic capability for hospitals, ACOs, and payers preparing for downside risk (Premier on CJR-X).
Related Articles
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Reforming Risk Adjustment in Medicare Advantage—A View From Congress
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Audit Readiness is Decided Months Before the First Chart Request Arrives
The following is a guest article by Michael Egbert, Chief Executive Officer at Sherpas Healthcare Solutions CMS has scaled Risk Adjustment Data Validation (RADV) to a degree the industry has never see...
Risk adjustment without the sprint: What outside leaders see that specialists miss
Risk adjustment without the sprint: What outside leaders see that specialists miss  Becker's Hospital Review
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