Developing a risk adjustment team that evolves with program needs
Today, health plans are navigating financial and regulatory challenges, including:
- Risk Adjustment model updates
- Star Ratings updates
- Interoperability mandates
- Increasing hiring and training costs
Health plans must continually monitor, respond to and streamline their risk adjustment program management.
Our experienced team operates in collaboration with yours
End-to-end services
We offer comprehensive risk adjustment services that reduce the need for multiple vendors. With over 20 years in the risk adjustment industry, you can rely on Optum to help implement an effective program.
Strategic edge
We combine insight with operational excellence that translates your vision and goals into an actionable, results-driven program strategy. Our data-driven interventions, combined with executive and strategic support, help create a competitive edge across your risk adjustment organizations.
Scalability
Quickly execute your risk adjustment initiatives and increase scalability across your programs with ease. Optum has simplified workflows and experts to help refine your strategies without sacrificing quality or transparency, helping deliver measurable outcomes with confidence.
Dedicated team of experts
Get access to a dedicated team led by industry experts who help design and facilitate risk adjustment programs for your organization, operating as an extension of your team. The team helps deliver a coordinated risk adjustment strategy and partnership that can help reduce your administrative overhead and hiring efforts.
Key benefits
End-to-end strategic support
We offer comprehensive program implementation through strategic, operational and domain expertise.
Executive performance updates
We provide regular updates with quantitative results and dashboards for informed risk adjustment program decisions.
Reduced administrative burden
Our simplified workflows help minimize complexity and internal resource strain.
Data-driven interventions
Our enhanced coding accuracy and faster chart retrieval enables earlier interventions, helping optimize program outcomes.
Increased productivity
We offer streamlined workflows that help improve operational efficiency and outcomes.
Continual performance improvements
Our ongoing optimization through analytics helps with sustained plan performance improvement.
Our 5-phased implementation approach
Discovery and strategic alignment: Assess current programs, align on goals and establish baselines.
Design and mobilization: Define strategy, workflows and plan execution.
Execution and monitoring: Activate workstreams and monitor performance.
Optimization: Refine strategies based on performance data.
Steady state: Achieve predictable and stable program performance.
Industry insights
Report
Examine the trends reshaping risk adjustment and learn how your organization can stay ahead in 2026.
Article
Learn how Optum helps health plans improve performance by using data, AI and smart technology to enhance accuracy, efficiency and integration.
Infographic
Learn 8 advantages of an end-to-end risk adjustment platform.
Product information and resources
-
Download sell sheet
PDF
Sell sheet
Overview of the Risk Adjustment Service Organization
Learn how Optum can help your organization design and implement risk adjustment programs and improve outcomes.