The COVID-19 pandemic has sent a tsunami through the business of risk adjustment (RA). Thriving through it is all about reimagining and finding opportunities.

My COVID-19 risk adjustment series continues with how those in the RA business can navigate returning to a “pseudo normalcy,” and where the opportunities are.

In this article I address making our plan/provider partnerships work smoothly, both operationally and technologically, as we open up again.

This article priorities in risk adjustment through the end of 2020, and how changes in our world wrought by the Coronavirus Pandemic may guide us.

This is the first in a series of articles by Will Stabler exploring consumerism in healthcare and potential models for a consumer-centric healthcare system.

In this article we explore one hypothetical consumer-driven healthcare ecosystem might look like by putting the power into the hands of the patient & provider.

In this article we look at a hypothetical multiple-payer system in which we keep private health insurers and employers working together in the driver’s seat.

The third article in this healthcare consumerism series by Will Stabler explores a hypothetical model that makes the government the single payer?

No matter how you slice it, acquisitions are about growth and therefore about sales. So the decision to do a deal should be weighed explicitly...

While the role and end objectives of acquisitions and sales are essentially the same, the execution processes are quite different.

This third article in Will Stabler's Growth series addresses the value of making acquisitions that have an explicit role in your strategic plan.

Interoperability is how we get to data that can empower patients to become more involved in their health care to benefit them, plans, providers and...

Challenges are many in interoperability, including reluctance to share information, competitive advantage for both providers & developers, costs & liability.

This article examines the two most important users of healthcare information—the clinician and the patient—and where they interface, in the EHR.

Everyone involved in EHR interoperability and adoption needs to take seriously physician concerns over loss of patient interaction & the squeeze on time that can...

We need patients using their health information and giving their feedback to clinicians in shared decision making and care management relationships.

Interoperability should eventually take us to a place where patients and providers are enabled to work as a team toward preventive medicine & value-based care.

As America's healthcare system transitions toward payment models rewarding what many call value-based care, risk adjustment is playing an crucial role.

In this article I look at how risk was modeled in the Medicare Advantage program and by the ACA before diving into more advanced risk...

As models and reporting evolves, it becomes critical for us to appreciate how risk adjustment, quality & care management measures can work together for success.

In achieving accurate risk adjustment results, many plans fall short in properly identifying the illness burden, and monitoring and managing data submissions.

In risk adjustment, variation can be the enemy. It can also provide opportunities if properly managed. The point of care is one place where we...