Risk Adjustment Programs & Program Management

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Risk Adjustment Programs & Program Management

Comprehensive and Balanced Risk Adjustment Solutions

Advantasure’s comprehensive risk adjustment program can help you achieve accurate, complete and compliant risk score accuracy.

Managing and minimizing risk is an important function of every successful health plan. Without special attention to data submissions, provider engagement, member contact and the other facets of risk management, a plan could experience lost or missed revenue, increased expenses and a myriad of other waste. All Medicare Advantage plans need to maximize the effectiveness of their risk adjustment initiatives to be successful. Creating an integrated, end-to-end risk adjustment program can seem like a monumental task, but with the right expertise, a seamless implementation is within reach.

Collaboration Drives Results

That’s where Advantasure comes in. Piece by piece, our team of industry experts eliminates the guesswork surrounding risk adjustment and provides a clear way forward to a tailored program designed to meet your plan’s unique goals. We dig deep into member profiles and provider performance to conduct condition-specific analysis and create accurate, effective outcomes. Then, we combine our innovative platforms with expertise and proven strategies to:

  • Drive provider engagement
  • Increase contact with your members
  • Accelerate improved results

For optimal efficiency across plan operations, you can bundle our risk adjustment program with our quality, administrative and care management solutions to further enhance your ability to leverage our capabilities.

Program options available to find the solution to fit your needs

  • Bid process input
  • Data-driven strategy development
  • Value and cost projections
  • Member risk adjustment gap identification
  • Provider performance, education and reporting
  • Prospective and retrospective initiative execution and management
  • In-home assessments
  • RAPS and EDPS submissions, error correction and reconciliation
  • RADV risk mitigation and audit support
  • Performance management reporting
Advantasure manages over $5 billion in risk-adjustment-related revenue for clients.

Working hand-in-hand with our clients, Advantasure strives to reduce risk from your list of worries. The strategies that we’ve created, and the new innovations we are rolling out each year, have given us a risk adjustment platform that is second to none.

If your plan’s risk scores are something you struggle to keep under control, let’s talk about how we can help.

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