Things have changed, we are in a new economy which demands that healthcare providers find new ways to connect with consumers and Altegra health is doing just that. They lead the health industry with information and product solutions, and contemporary health services by aligning a continuous monitoring and reporting program with the consumer to ensure members are appropriately risk-adjusted, and in turn, qualify for appropriate payment. Due to the many complexities of the health care system risk adjustment is a very important process to the system.

Risk adjustment is a transfer mechanism whereby money flows from insurers with healthy customers to insurers with sick customers, the transfers are based on how sick the customers were when the insurers got them at the beginning of the year, not the other way around- because then you would be penalizing insurers that are actually good at making people more healthy- which is the idea of health care. Another great way to help keep risk adjustment on track will come from the providers coding; more coding for every diagnosis will start immediately, which in turn will help with the adjustments.

Speaking of staying on top of health care news; the topic of Risk assessment and risk adjustments are getting lots of press right now and for good reason; With the new health care reform act, the traditional underwriting, pricing and provider payments has all changed.

By using Altegra health for risk adjustment you can improve the fairness of the state’s capitation rate setting system, this allows for a greater promotion of the plan and provider participation.

Altegra health leads the industry in technology applications by providing continuous monitoring of risk scores to ensure members are appropriately risk-adjusted and, in turn, qualify for calibrated premiums, which enables health plans and their subcontractors to report their Medicaid Encounter data completely, accurately, and timely in a cost effective and efficient way. When you have complete and accurate data you allow for cost control and quality initiatives which improves the over all health care system for everyone.

Everyone agrees that Altegra Health is number one in the nation when it comes to Risk Adjustment due to continuous monitoring of risk scores to ensure members are appropriately risk-adjusted and, in turn, qualify for calibrated premiums.