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Navigating Risk Adjustment in 2025: A Guide for Health Plans
Manage episode 463721923 series 3591484
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Join Joe Boyle, President of Regulatory Solutions at Penstock, as he breaks down CMS’s risk adjustment and user fee updates for benefit year 2025. This episode is your go-to guide for navigating the evolving regulatory landscape.
Here’s What You’ll Learn:
- How CMS’s use of 2019–2021 data impacts 2025 submissions
- The role of the American Rescue Plan in shaping membership trends and user fees
- Key strategies for issuers entering new markets
- Tips for compliance when serving AI/AN populations
- Why predictive modeling is the future of risk adjustment
Whether you’re an established issuer or entering a new market, this episode is packed with actionable insights and practical recommendations to help you stay compliant, optimize processes, and prepare for the future of risk adjustment.
🎧 Listen now and make sure your team is ready for the 2025 submission season. Subscribe to Regulatory Joe for updates on regulatory filing for health plans, compliance tips, and more.
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