Increasingly commercial programs are implementing broadly sweeping risk adjustment initiatives. For traditional regional commercial plans as well as for a range of service delivery formats such as contracted IPAs or hospital networks, a shared risk component of reimbursement is increasingly common throughout the United States.

In each risk related reimbursement model the importance of detailed claims analysis, completeness, appropriate correction and reporting is critical to facilitate contract negotiations, bid submission, financial forecasting, risk adjustment, and financial reimbursement recognition.

MedAssurant’s Capitation Risk Adjustment (CARA) solution provides an end-to-end solution that accommodates variances in risk model to analyze, adjust, and report to the wide array of commercial risk adjustment needs in the marketplace.