How can risk adjusters improve the accuracy of value-based payment?

Providers should understand the health insurance risk they assume through value-based payment contracts, and how this might impact their reimbursements. Risk adjustment tools like the Milliman Advanced Risk Adjusters™ (MARA™) suite identify and isolate morbidity risk factors that are beyond a provider’s control. This may result in payments that more accurately reflect a patient population’s controllable risk. In this article, Milliman’s Colleen Norris and Stoddard Davenport demonstrate how risk adjustment can minimize the financial exposure associated with the morbidity risk that providers cannot influence.

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