Risk adjustment
Balancing the scales
Milliman risk adjustment solutions
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The industry’s most precise risk adjuster
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We know risk adjustment better than anyone
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Dig deeper into your healthcare data
Learn moreMilliman risk adjustment insight
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ACA risk adjustment management
Many issuers in the ACA don’t have a comprehensive risk adjustment strategy—leading to lost opportunities and less-certain financial outcomes. In this series, we provide guidance on creating a risk adjustment program to address these gaps.
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Risk adjustment in CMS episode-based payment models: A resource guide
In recent years, CMS has implemented a variety of episode-based payment models. This paper provides a high-level guide to the unique and complex risk arrangements for providers under four of these models.
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Medicare Advantage risk score primer
Quickly learn the fundamentals of risk scoring for Medicare Advantage plans, including the impact of diagnosis submission on payment timing.
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Functional-based risk adjustment for Medicaid long term care
Understand the benefits of shifting from location-based to functional risk adjustment in Medicaid Managed Long Term Services and Supports (MLTSS) programs.
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How Monterey is reinventing healthcare
When confronted with rising costs and shrinking reimbursement, leaders at a hospital in California took a bold step to ensure that they could continue serving the needs of the community in a financially sustainable way.