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Managing Medicaid risk adjustment is almost never a top priority. State by state regulations differ, making it complicated and costly to perform, and it is not often financially worth the trouble. Medicaid risk adjustment is effectively budget neutral, in that the funding is a fixed pool, apportioning dollars between organizations covering those lives based on […]
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Strategies for Different Patient Populations and Payment Models
One-size doesn't fit all when it comes to the underlying risk adjustment strategies health plans should pursue given the market(s) that they participate in.
Tag: Medicaid
Medicaid Insights: Risk Adjustment
Medicaid Insights: Risk adjustment is essential to the success of any risk-based payment model, including many medicaid programs. For most states, payments are based upon how a plan’s risk score ranks against other Medicaid plans in the same state or sub-state region rather than the plan’s risk score itself. Find out more about risk adjustment for Medicaid programs in our blog.
