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Aligning Payer-Provider Incentives to Improve Coding and ACA Risk Transfer Payments
Milliman Link to more items from this source
Dec. 24, 2015

"Experience for 2014 showed the impact of risk adjustment can be substantial, and health plans operating under the ACA need a thoughtful, innovative plan for managing risk scores.... Health plans should engage providers in their networks to code diagnoses accurately and completely. The most effective initiatives occur when the incentives of health plans and providers are aligned, and they work together to coordinate coding efforts. A successful risk adjustment strategy includes continuous monitoring and strong execution by both the health plan and the providers."

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