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Insights That Move Healthcare

Expert perspectives on revenue cycle, risk adjustment, compliance, and healthcare strategy – designed to help providers, plans, and leaders make smarter operational and financial decisions.

Prospective, Concurrent, and Retrospective Ri...

Risk adjustment is often discussed as a Medicare Advantage problem. In actuality, it affects every organization whose reimbursement, shared savings, or quality performance depends on accurately reflecting the complexity of their patient population.

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prospective concurrent retrospective risk adjustment 2026 guide MA plans ACOs
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HCC risk adjustment coding defensible Medicare Advantage RADV
June 12, 2026

The New Era of HCC Risk Adjustment: W...

For years, many Medicare Advantage organizations treated HCC risk adjustment as a volume exercise: capture more diagnose...

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risk adjustment coding companies
May 05, 2026

Risk Adjustment & HEDIS in 2026: Why ...

In 2026, health plans, Medicare Advantage organizations, and risk adjustment coding companies across the US face growing...

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Risk Adjustment Medical Coding
June 06, 2025

The 2026 Medicare Advantage Final Rul...

The Centers for Medicare & Medicaid Services' (CMS) CY 2026 Rate Announcement introduces significant updates that direct...

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Accurate HCC Risk Adjustment
May 16, 2025

How Accurate HCC Risk Adjustment Can ...

As the healthcare industry continues to shift toward value-based care, precise Hierarchical Condition Category (HCC) ris...

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