Risk Adjustment Programs and Program Management

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Risk Adjustment Programs and Program Management

Comprehensive and Balanced

Creating an integrated, end-to-end risk adjustment program can seem like a monumental task. It requires the seamless integration of strategy development, execution, management and reporting.

That’s where Advantasure comes in. Piece by piece, our team of industry experts eliminates the guesswork in 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 tailor accurate, effective outcomes. Then, we combine our innovative solution with expertise and guidance 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.

Program Options

  • 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
  • Performance management reporting
  • RAPS and EDPS submissions, error correction, and reconciliation
  • Risk score and documentation accuracy assessment
  • Condition-specific risk adjustment leakage analysis
  • RADV risk mitigation and audit support
  • In-home assessments
Advantasure manages over $5 billion in risk-adjustment-related revenue for clients. Together, we’ve helped them achieve a 99% new-enrollment success rate.

Find Out How We Fuel Accelerated Performance

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