{"id":325222,"date":"2025-11-30T22:47:03","date_gmt":"2025-11-30T22:47:03","guid":{"rendered":"https:\/\/peraltafinancing.com\/uncategorized\/an-innovation-roadmap-for-risk-adjustment-strategies\/"},"modified":"2025-11-30T22:47:03","modified_gmt":"2025-11-30T22:47:03","slug":"an-innovation-roadmap-for-risk-adjustment-strategies","status":"publish","type":"post","link":"https:\/\/fivemor.com\/?p=325222","title":{"rendered":"An innovation roadmap for risk adjustment strategies"},"content":{"rendered":"<p> <br \/>\n<\/p>\n<div id=\"hs_cos_wrapper_post_body\">\n<p>New dynamics in risk adjustment are prompting health plans to rethink their strategies for 2026 and beyond. With regulatory changes and evolving audit methodologies on the horizon, health plans are investing in prospective and concurrent approaches alongside their traditional retrospective programs to help ensure sustainability, improve coding accuracy, and strengthen compliance.<\/p>\n<p><strong>In a new episode of the RISE Radio podcast, senior leaders from Cotiviti and Edifecs offer strategies for building scalable risk adjustment technology initiatives while navigating rising business and regulatory pressures. <!--more--><\/strong><\/p>\n<p style=\"margin-top: 25px;\"><iframe loading=\"lazy\" style=\"max-width: 660px; overflow: hidden; border-radius: 10px; display: table; margin-left: auto; margin-right: auto; margin: 0px auto;\" allow=\"autoplay *; encrypted-media *; fullscreen *; clipboard-write\" xml=\"lang\" src=\"https:\/\/embed.podcasts.apple.com\/us\/podcast\/episode-27-innovation-roadmap-cotiviti-on-a\/id1555092425?i=1000737655209\" width=\"560\" height=\"175\" frameborder=\"0\" sandbox=\"allow-forms allow-popups allow-same-origin allow-scripts allow-storage-access-by-user-activation allow-top-navigation-by-user-activation\"><\/iframe><\/p>\n<p style=\"margin-top: 25px;\">Listen to the podcast featuring Branka Sustic, Cotiviti vice president of risk adjustment and quality, and Summerpal Kahlon, M.D., Edifecs chief medical officer, to learn more about:<\/p>\n<ul>\n<li>How to enhance data accuracy<\/li>\n<li>How to align tech investments with measurable impact<\/li>\n<li>How to build integrated risk adjustment strategies and better healthcare enablement<\/li>\n<\/ul>\n<p>You\u2019ll also learn more about how the combined strengths of Cotiviti and Edifecs are powering the next wave of innovation along the full risk adjustment lifecycle. Don\u2019t miss this opportunity to stay ahead as prospective and concurrent risk adjustment become increasingly vital to success.<\/p>\n<div style=\"background-color: #f2edfc; padding: 20px; margin-top: 25px;\">\n<p>For more information on structuring your plan for risk adjustment success in the new year and beyond, read our new checklist on how to create a comprehensive risk adjustment program. You\u2019ll learn a concrete action plan framework for both short- and long-term success along with critical KPIs to track and improve impact.<\/p>\n<div class=\"hs-cta-embed hs-cta-simple-placeholder hs-cta-embed-200467319891\" style=\"max-width:100%; max-height:100%; width:220px;height:42.38888931274414px\" data-hubspot-wrapper-cta-id=\"200467319891\">\n  <a href=\"https:\/\/blog.cotiviti.com\/hs\/cta\/wi\/redirect?encryptedPayload=AVxigLLmyxkeYK3aY5v66XqyE5boVm2QiSoWTYSHgEl5dhxZc3w%2FXIeZEHnxSIdu8fQUfuMJ7Z57%2BzrF9DwFD7HPTp08FifGMOU%2Bj4vR25g1slhkwWgber6E0XMmQ8AkitlWrCwpNOcxhMs219FIsDf%2FT%2BK06wJBU2b2RPFNLqm4xHFfLfYBMXSO87eHigUGhn%2BxQfFuagjvM58W%2Fe8Cpj%2FMosozHQnguNq2hLxn%2FoxdAXFfSgV8fYB8V78Iv1sJerOP4dNtPibBKXI%3D&amp;webInteractiveContentId=200467319891&amp;portalId=394315\" target=\"_blank\" rel=\"noopener\" crossorigin=\"anonymous\"><br \/>\n    <img decoding=\"async\" alt=\"Read the checklist\" loading=\"lazy\" src=\"https:\/\/no-cache.hubspot.com\/cta\/default\/394315\/interactive-200467319891.png\" style=\"height: 100%; width: 100%; object-fit: fill\" onerror=\"this.style.display='none'\"\/><br \/>\n  <\/a>\n<\/div>\n<\/div>\n<table style=\"width: 100%; height: 477.562px; margin-top: 25px; border-width: 0px; border-style: solid;\">\n<tbody>\n<tr>\n<td class=\"block\" style=\"vertical-align: top; width: 23.8095%;\" width=\"200\">\n<p><img decoding=\"async\" alt=\"Katie Devlin, DHSc, MS, CPHIMS\" src=\"https:\/\/res.cloudinary.com\/uf-555044\/image\/upload\/v1758808130\/BrankaSustic_2_200x200_ysgkcc.png\" style=\"width: 150px;\" height=\"150\"\/><\/p>\n<\/td>\n<td class=\"block\" style=\"vertical-align: top; width: 72.7902%;\">\n<p><strong>Branka Sustic, M.S.<\/strong><br \/><strong>Vice President of Risk Adjustment and Quality, Cotiviti<\/strong><\/p>\n<p>Branka provides leadership in product and business development, client program management, and strategy to assist health plans in meeting their quality goals, optimization of revenue, and risk mitigation. A leader with more than 20 years of healthcare experience, she is known for creating and establishing operational and support plans leading to increased client satisfaction and performance.<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td class=\"block\" style=\"vertical-align: top; width: 23.8095%;\" width=\"200\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/res.cloudinary.com\/uf-555044\/image\/upload\/v1763757310\/SummerpalKahlon_200x200_tafygs.png\" width=\"150\" height=\"150\" alt=\"\"\/><\/td>\n<td class=\"block\" style=\"vertical-align: top; width: 72.7902%;\">\n<p>\u00a0<\/p>\n<p><strong>Summerpal Kahlon, M.D.<\/strong><br \/><strong>Chief Medical Officer, Edifecs<\/strong><\/p>\n<p>Dr. Kahlon works across products and functions to guide clinical strategies and policies. His career spans over 20 years of experience in diverse health care settings, businesses, and markets. Dr. Kahlon has deep expertise in value-based care and risk adjustment, and brings unique insight to help customers make the most comprehensive, informed, and clinically relevant decisions for their populations. He is a practicing physician with Veterans Affairs and an assistant professor of internal medicine at the University of Central Florida.\u00a0<\/p>\n<p>\u00a0<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<p><script>(function(d, s, id) {\n  var js, fjs = d.getElementsByTagName(s)[0];\n  if (d.getElementById(id)) return;\n  js = d.createElement(s); js.id = id;\n  js.src = \"\/\/connect.facebook.net\/en_GB\/sdk.js#xfbml=1&version=v3.0\";\n  fjs.parentNode.insertBefore(js, fjs);\n }(document, 'script', 'facebook-jssdk'));<\/script><br \/>\n<br \/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>New dynamics in risk adjustment are prompting health plans to rethink their strategies for 2026 and beyond. With regulatory changes and evolving audit methodologies on the horizon, health plans are investing in prospective and concurrent approaches alongside their traditional retrospective programs to help ensure sustainability, improve coding accuracy, and strengthen compliance. In a new episode [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":325223,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[152131],"tags":[1451,11187,11115,19449,11124],"dealstore":[],"offerexpiration":[],"class_list":["post-325222","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-risk-adjustment","tag-adjustment","tag-innovation","tag-risk","tag-roadmap","tag-strategies"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>An innovation roadmap for risk adjustment strategies - Som2ny Network<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fivemor.com\/?p=325222\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"An innovation roadmap for risk adjustment strategies - Som2ny Network\" \/>\n<meta property=\"og:description\" content=\"New dynamics in risk adjustment are prompting health plans to rethink their strategies for 2026 and beyond. 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