Navigating Risk Adjustment Challenges: Federal Initiatives and Operational Strategies for Healthcare Sustainability

Federally sponsored healthcare programs — Medicare and Medicaid among them — serve as cornerstones of the United States healthcare system, offering cardinal services to millions of Americans who otherwise would be left without accessible medical care. Within this system, risk adjustment serves as a mechanism in ensuring the fair, accurate, and sustainable allocation of resources.

The following white paper presents an analysis and forecast by ZeOmega’s experts in risk adjustment solutions. It focuses on regulatory changes and provides guidance on ensuring accurate risk payments in both business and clinical operations