Risk Adjustment

EMSI Health was an early leader in risk-adjustment services in the Medicare Advantage market. Leveraging that expertise, we also built an industry-leading risk-adjustment solution for the Health Insurance Marketplace. We identify claims data highly correlated to relevant HCCs to reveal members with insufficient coding.  Our comprehensive health evaluation delivery system for prospective, retrospective and concurrent risk adjustment reviews provide health plans with specific documentation on members’ health diagnoses and conditions to maximize the effectiveness of risk-adjustment initiatives.

Learn more about what we can do to help you succeed in the Health Insurance Marketplace. Contact us today.