Health plan revenue is increasingly tied to the concept of risk adjustment. In practice, risk adjustment aligns payments received by health plans with the risk of the populations they manage. Although each market has its own unique version of risk…

MACRA offers provider organizations strategic opportunities to think differently about their business models and pursue sustainable growth and margin levels. With increased accountability stemming from MACRA and related APMs, patient economics has come at the forefront of long-term strategy development.…

Our last briefing, It Takes Three to Tango, describes how a partnership framework involving carriers, providers, and consumers can be designed to drive improved health outcomes and sustainable financial stability. The collaboration model is comprised of two integrated parts—a Product…