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CMS has launched its Payment Year 2020 Contract-level RADV audit process, giving selected Medicare Advantage health plans access to sampled members and HCCs — with PY2021 audits expected to begin
Latest Insights
CMS’ Race to Validate: Navigating the Rapid RADV Era
The Real Job of a Star Ratings Team
The 3 Biggest Star Takeaways From The 2027 MAPD Rule
On-Demand Webinars
Beyond the Noise: Insights on the 2026 CMS Star Ratings
How to Accelerate Your Risk Adjustment Strategy
Unlocking Success: Best Practices for Monitoring Health Plan Data Submissions to CMS
Tools & Reports
Interactive Analysis: 2024 ACA Risk Adjustment Transfer Payment Results
On June 30th, 2025, the Department of Health and Human Services (HHS) unveiled the highly anticipated Summary Report on Individual and Small Group Market Risk Adjustment Transfers for the 2024 Benefit
Interactive Analysis: 2023 ACA Risk Adjustment Transfer Payment Results
On July 22, 2024, the Department of Health and Human Services (HHS) unveiled the highly anticipated Summary Report on Risk Adjustment Transfer for the 2023 Benefit Year. This report dives into
Success Stories
How Blue Cross of Idaho Modernized Provider Communication to Improve Risk & Quality Outcomes
Improving Medicare Advantage Risk Submission Accuracy Through Data Integrity Analytics
How an ACA Plan Identified $7.7M in Suppressed Risk Transfer
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