CASE STUDY SPOTLIGHT

Learn How Three Health Plans Achieved Significant ROI in Risk Adjustment

Population Advyzer was employed to improve the efficiency of three health plans’ risk adjustment programs while helping them reach or surpass previous years’ results. While each plan faced unique market dynamics, geographic considerations, and provider affiliations, the Population Advyzer playbook was effective in every case.

Medicare and ACA populations and providers are constantly in flux. Therefore, delivering accurate risk scores and impactful interventions for these programs requires intense time and attention. Without that focus, members’ health and BCBS Plans’ revenue are in jeopardy.

BHI's Alan Spiro, MD, and Maria Ferrera lead a discussion around how low-cost, low-value care services are driving an increase in unnecessary care costs, and why targeting low-value care services represents a significant savings opportunity for payers.

Today, health plans are sharing a greater portion of risk and savings with providers. Now, it's imperative that patients are effectively evaluated and treated to prevent both readmissions and avoidable emergency department (ED) visits.