Risk adjustment without the sprint: What outside leaders see that specialists miss

Most Medicare Advantage plans still run risk adjustment the way they always have — as a specialized function, staffed and led by risk adjustment experts.

That specialization built deep expertise, but it also built blind spots. Leaders trained in actuarial science, informatics and enterprise operations tend to measure efficiency and think in systems, and they catch inefficiencies that a career risk adjustment team stops seeing.

This session brings together leaders from inside and outside traditional risk adjustment to show what a more continuous, connected operation looks like, and how to build one.