The recent rise in Medicare Advantage beneficiaries, coupled with stringent regulatory requirements, has compelled payers to effectively stratify and analyze the risk of their members. The implementation of risk adjustment not only assists health plans in meeting the ACA mandates but also facilitates enterprises in improving care delivery, reducing medical expenses, and simplifying provider payments. Consequently, payers are seeking to capitalize on risk adjustment technology solutions to expedite their risk assessment and reimbursement processes.
In this report, we examine the risk adjustment solution domain by identifying emerging trends, scrutinizing different market offerings, and evaluating available capabilities against market requirements. The report also provides valuable insights for payers looking to leverage risk adjustment technology solutions and gain a competitive edge in the market.
Scope
Industry: healthcare payers
Geography: global
Contents
In this report, we examine:
Drivers and challenges of risk adjustment solutions
Trends in risk adjustment
Models of risk adjustment solutions
Use cases of risk adjustment for both payers and providers
Care management is an all-encompassing healthcare approach that provides timely and suitable care to individuals. In the past, payers did not prioritize care management; however, there has been a notable shift in this trend. Payers now recognize the…
