Healthcare providers and payers have long been focused on minimizing financial risks and ensuring the accuracy of claims. Risk Adjustment Solution is a set of tools and strategies designed to assess and predict healthcare costs accurately, enabling organizations to receive the appropriate level of reimbursement from government-sponsored programs and insurance providers.
Interpretation of Risk Adjustment
Risk adjustment is a method that assesses the health status of a patient population to determine the appropriate level of funding. It takes into account the health and demographic information of patients to calculate risk scores, which are used to predict healthcare costs accurately. Risk Adjustment is crucial for government-sponsored programs like Medicare Advantage and Medicaid, as well as commercial health insurance.

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