We help health plans and risk-bearing providers improve outcomes across their risk adjustment and quality programs.
Risk adjustment is evolving beyond the identification and capture of diagnoses. As Medicare Advantage programs become more complex and regulatory expectations continue to change, health plans are placing greater emphasis on building programs that are accurate, connected, and support long-term compliance readiness. Increasingly, success depends not only on identifying conditions, but on what happens next—from… Continue reading One Partner. One Strategy. Confident Compliance.
On January 26, 2026, the Centers for Medicare & Medicaid Services (CMS) released the 2027 Advanced Notice for Medicare Advantage (MA) plans, detailing proposed changes to MA capitation rates and Part C and Part D payment policies. The updates reflect CMS’s continued focus on payment accuracy, data integrity, and alignment with Original Medicare, with meaningful implications for… Continue reading 2027 CMS Advance Notice: Risk Adjustment and Quality Impacts for Medicare Advantage Plans
On January 10, CMS released the 2026 Advance Notice for Medicare Advantage (MA) plans, detailing proposed changes to MA capitation rates and Part C and Part D payment policies. This notice brings significant updates, including the full implementation of the V28 risk adjustment model for CY 2026, projected payment adjustments, and shifts in Part D… Continue reading 2026 CMS Advance Notice: Impacts on Medicare Advantage
