Healthcare is on the path toward more proactive and personalized care, and an accurate narrative about patient healthcare is the foundation for understanding what works and what does not. The ...

Capturing accurate diagnostic codes through comprehensive risk adjustment programs has become increasingly important for provider-sponsored health plans to improve patient care and clinical quality.

Discover how the risk-adjusted discount rate reflects investment risk and return, helping you to evaluate the valuation of projects with potential risk.

In an individual insurance market, plan payments are risk-adjusted to limit distortions in plan offerings that arise from incentives to select favorable risks. With this objective in mind, risk ...

Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...

On January 13, 2025, the Department of Health and Human Services (HHS) published a final rule that contained the 2026 HHS Notice of Benefit Payment Parameters and certain policy changes related to the ...

High risk-adjusted returns suggest efficient performance for the invested capital. Low risk-adjusted returns indicate potentially suboptimal investments. Comparing risk-adjusted returns helps select ...

Please provide your email address to receive an email when new articles are posted on . In business, the focus on consistent outcomes includes managing “inputs,” such as uniform materials and ...

SEATTLE, March 10, 2025 /PRNewswire/ — Milliman MedInsight ®, a leading provider of healthcare data and analytics, announced today the launch of a comprehensive, end-to-end risk adjustment workflow ...

Combining EM, DM, and US improves portfolio risk-adjusted returns due to their uncorrelation. EM offers higher returns but more risk, while DM adds stability; blending them enhances outcomes. Vanguard ...

Major insurers are gaming Medicare Advantage’s risk adjustment system to reap higher payments from the government, costing Medicare billions of dollars, according to a new analysis of CMS data.

New data analysis shows stark variation in risk adjustment from abusive industry practices WASHINGTON, Sept. 3, 2025 /PRNewswire/ -- New analysis by the Alliance of Community Health Plans (ACHP) shows ...