Risk Adjustment
Program Assessment

Analytics Experts, At Your Service

Make sense of your risk adjustment data with our analytics consulting service.

About the Service

Understanding risk adjustment data can be challenging, and standard technology solutions are often one-size-fits-all. That’s why we’ve created a solution that combines the technology and expert teams you need to unlock clinically relevant insights specific to your patient population.

We start with the full power of our analytics technology, and then apply the deep subject matter expertise of our risk adjustment team to provide a 360º view of your risk adjustment program performance — where it is today, what’s working, and what isn’t. 

Features

Risk Score Reporting

Our analytics team will create a comprehensive report on year-over-year risk score trends, as well as how your organization’s risk score performs against CMS benchmarks. In addition, we not only identify areas of risk score opportunity, but also estimate their potential value.

Disease Prevalence Insights

Our analytics team provides insights into the top suspected diseases in your patient population.

Comprehensive Benchmarking

We measure the success of your risk adjustment program against both past performance and CMS benchmarks.

Actionable Task Lists

We identify patients who need immediate care, and unengaged patients that require outreach. We also provide you with a list of clinicians that have a higher or lower than average patient engagement rate, as well as those that have a higher or lower than average percentage of high-risk patients.

Full Consulting Support

With Risk Adjustment Program Assessment, you’ll be partnered with a dedicated project team, as well as a group of data strategists, product directors, and analysts.

End-to-End Execution

Beyond just delivering analysis, we have the ability to carry out many of the recommendations we make, from retrieval to coding — and more.

How It Works

Execute earlier interventions

Fuel your prospective care strategy

Gain visibility into value-based care performance

Reduce administrative burden

Improve quality of care

Our Impact

0 %

YOY increase in risk score for Medicaid clients

0 %

YOY increase in risk score opportunity for Medicaid clients

$ 0

PMPM identified in average revenue opportunity across multiple health plan clients

Testimonials

Episource Client

I am impressed by the level of preparation and comprehensive analysis; it is far beyond what we are used to receiving from a vendor.

Episource Client

The presentation inspired us to begin using the data points to prepare for our key Internal Risk Adjustment Workgroup with upper management and grade ourselves on how we can improve our processes.

Episource Client

Episource found a lost revenue opportunity of about $428 per member per month.

Additional Resources