Risk adjustment solutions for Medicare Advantage organizations are entering 2027 under a confirmed payment environment and a set of operational changes that require adaptation before January 1. CMS's April 2026 Rate Announcement projects MA payments to increase by 2.48% – over $13 billion – in CY 2027, while CMS expects MA risk scores to increase by 2.50% on average due to underlying coding trends [1]

The CMS Transforming Episode Accountability Model (TEAM) is in play, and its impact on orthopedic billing services will ...
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Risk adjustment is often discussed as a Medicare Advantage problem. In actuality, it affects every organization whose re...
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For years, many Medicare Advantage organizations treated HCC risk adjustment as a volume exercise: capture more diagnose...
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In 2026, Medicare Advantage risk adjustment is no longer just a coding exercise. It has become a high-stakes operational...
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Remote Patient Monitoring (RPM) billing sounds like one of those healthcare ideas that should be simple: Patients stay h...
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In 2026, health plans, Medicare Advantage organizations, and risk adjustment coding companies across the US face growing...
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Risk adjustment audits are changing again, and leaders in charge of risk adjustment services should take note as the imp...
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Accuracy gets all the attention in risk adjustment coding, and rightly so. It’s the backbone of compliance, reimbursemen...
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In today’s value-based healthcare environment, risk adjustment medical coders are essential to the financial health, reg...
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