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Risk Adjustment Is a Partnership???

Risk Adjustment Is a Partnership???

Under the risk adjustment (RA) model, reimbursements to the insurance companies (Plans) are based on the member’s level of severity of illness rather than the number and types of interventions the member receives throughout the year. This reimbursement model is based...
Are You Ready For The 2024 Risk Adjustment Model?

Are You Ready For The 2024 Risk Adjustment Model?

This article, as part of the SunHawk Consulting team’s Medical Risk Adjustment compliance as well as statistical sampling & coding audit services, gives a high level overview of some upcoming changes for 2024 in the CMS Risk Adjustment model, V28. The CMS-HCC Risk...