The Risk Adjustment Forum 2015

Risk adjustment is the keystone to long-term solvency in the post-ACA healthcare market. Carriers with mastery over risk adjustment will thrive in this new environment, while those with poor risk adjustment programs will fall behind. With the zero-sum model in place, commercial & exchange plans face serious challenges to their bottom lines. Meanwhile, Medicaid Advantage plans struggle to keep up with all the ACA changes, HCC changes, and the impending ICD10 transition. Medicaid expansion and the rise in managed care has brought risk adjustment front and center for Medicaid plans as well. With such high stakes it’s no wonder risk adjustment has become such a focal point for carriers on all fronts!