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Navigating Payment Integrity: Strategies For Success In 2024

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The Risk Adjustment Digest

Guides + White Papers

The Risk Adjustment Digest

Use of proper risk adjustment data. The way that America pays for healthcare is changing completely. We are moving away from a “fee‑for‑service” healthcare system, where clinicians are paid for every service provided, to a “fee‑for‑value” one where teams of clinicians are paid to keep individuals healthy in a cost‑effective way. Studies have shown that “fee-for‑service” payment incentivizes too much care, which is often inappropriate or simply wasteful. In a value‑based payment world, hospitals and health systems will profit by caring for populations and enabling better health outcomes at lower costs.

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