Fast Break: Risk Adjustment and Liability

As managed and value-based care models continue their resurgence in the healthcare marketplace, emphasis on the use of risk adjustment and related statistical processes to ensure adequate health care outcomes and costs has increased. More recently, federal enforcement agencies have focused on risk adjustment reporting to ensure that the data and funds generated by health plans are accurate and appropriate.

In this month's Fast Break, Tesch Leigh West and Michelle M. Arra will join us for a discussion on the growing importance of risk adjustment in various health insurance programs and novel government theories of liability associated with risk adjustment reporting.

TOPICS WILL INCLUDE:

• Risk Adjustment—the Basics
• Risk Adjustment in Federal Health Care Programs
• Medicare Risk Adjustment Data Validation (RADV) Program
• Areas of Exposure and Liability
• Best Practices for Ensuring Accurate Reporting