Risk Adjustments

Risk adjustment is an actuarial tool used to calibrate payment to health plans or other stakeholders based on the relative health of the at-risk population. Risk adjustment is used to adjust bidding and payment based on the health status and demographic characteristics of a member. Risk scores measure members’ relative risk and risk scores are used to adjust payment for each member’s expected expenditures.

Risk Adjustment Best Practice


  • See each member at least once each year and complete an Annual Wellness Assessment (face-to-face visit). Health Plans have their specific forms and typically pays provider to complete the comprehensive assessment. Preferred IPA has a generic Annual Wellness Assessment form

  • Evaluate and document all chronic conditions and historical amputation(s) in the medical record, code all diagnosis using ICD-10-CM codes, and submit all diagnosis to Preferred IPA.

  • Coding: Providers need to link the chronic conditions to yield higher RAF scores in charts (linking conditions to medications and document manifestation of a condition: amputation due to poor control of diabetes).

  • Accurate Document

    • Condition Assessment: Stable, improved, tolerating meds, deteriorating, uncontrolled.

    • Example Conditions/Diseases: Chronic Kidney Disease, Cancer, Diabetes & associated manifestations, Hypertension, Chronic Obstructive Pulmonary Disease (COPD), Morbid Obesity, Major Depression, Cardiovascular Disease, etc.

    • Care Plan: Monitor, D/C Meds, continue current meds, refuses treatment, refer to specialist.

    • Acceptable Source Data: IP, OP and Physician Office Visits (Face-to-Face)

    • Exclude Data Source: SNF, Hospice, Nursing Homes, Lab, Radiology, Ambulance, DME, Ambulatory Surgery Centers.

References: Anthem Blue Cross

References: Anthem Blue Cross

Introduction to Risk Adjustment, Documentation & Coding Best Practices