Pulse8 to Address Medicaid Risk Adjustment at the Upcoming RISE Risk Adjustment Forum

With six different models across the various States, caps on cross-competitor premium increases, and restrictions on supplemental data, Medicaid is by far the trickiest, but, at Pulse8, we live for such challenges

In its 10th year, the annual RISE Risk Adjustment Forum focuses on content-driven topics and convenes top industry experts with years of experience and proven results in risk adjustment.

During this presentation, attendees will get a better understanding of Medicaid Risk Adjustment, including the following:


  • The differences in Risk Adjustment between Medicaid, Medicare Advantage, and ACA Commercial
  • The various Medicaid Risk Adjustment models and what states use them
  • Deep dive into the most commonly used model in Medicaid
  • Challenges that are especially acute in risk adjustment for Medicaid, such as primacy of the claim
  • Analytic capabilities needed by risk-bearing entities to obtain the best results in their Medicaid programs

“Each of the three risk-adjusted government lines of business – Medicaid, Medicare Advantage, and ACA Commercial – has its own unique model and market factors,” remarked Mr. Stratton. “The Product Team at Pulse8 is comprised of experts for each segment, who have collaborated to deploy the most advance clinical inferencing rules, risk adjustment algorithms, and quality measures specific to each market. With six different models across the various States, caps on cross-competitor premium increases, and restrictions on supplemental data, Medicaid is by far the trickiest, but, at Pulse8, we live for such challenges.”

About Pulse8

Pulse8 is the only Healthcare Analytics and Technology Company delivering complete visibility into the efficacy of your Risk Adjustment and Quality Management programs. We…

Read the full article from the Source…

Back to Top