Risk Stratification

Social Risk Adjustment Promotes Health Equity In Value Based Care

April 15, 2021 - Adjusting quality measures for social risk factors can promote health equity, according to expert guidance published in Health Affairs. As value-based payment programs expand, there is growing concern that reimbursement models could penalize providers who serve the most vulnerable populations is growing. The experts explained that while health...


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Health Orgs Support MA Risk Adjustment For Audio-Only Telehealth

by Hannah Nelson

Prominent healthcare organizations have announced their support of new legislation that would allow for audio-only telehealth services to apply toward Medicare Advantage (MA) risk adjustment. In a...

Cigna Embroiled in Lawsuit Over Wellness Program Risk Adjustment

by Kelsey Waddill

A lawsuit was filed against Cigna on August 4, 2020 for $1.4 billion in false and fraudulent risk adjustment claims between 2012 and 2017, according to a court filing obtained by Axios. The...

How Care Management, Risk Stratification Cuts Medicaid Spending

by Kelsey Waddill

Better care management and risk stratification can help state Medicaid agencies cut spending on high-cost patients, according to a recent report from the Government Accountability Office...