Healthcare is on the path toward more proactive and personalized care, and an accurate narrative about patient healthcare is the foundation for understanding what works and what does not. The ...

Capturing accurate diagnostic codes through comprehensive risk adjustment programs has become increasingly important for provider-sponsored health plans to improve patient care and clinical quality.

Humana has filed suit against the feds, saying the Biden administration's bid to claw back overpayments in Medicare Advantage (MA) is built on "shifting justifications and erroneous legal reasoning." ...

Financial struggles at Bright Health Group and Friday Health Plans have raised concerns about how well the Affordable Care Act's (ACA's) risk adjustment program is working, especially whether it's ...

Much of the recent news around the Affordable Care Act (ACA) marketplace has focused on anticipated premium increases for 2017. This should not be a surprise as there are several known factors that ...

If finalized, these proposals will generally take effect on January 1, 2025, unless otherwise noted. Both the individual and small group market risk adjustment system are based on a set of regression ...

Faced with new government regulations, Medicare Advantage (MA) organizations should be utilizing technology to increase the accuracy of their coding, mitigate their risk, and ensure appropriate care ...

DURHAM, N.C., Feb. 18, 2025 (GLOBE NEWSWIRE) -- Keebler Health, which provides the best AI-native risk adjustment platform for healthcare providers, announced today that it has raised a $6M seed round ...