Take the direct path to prospective risk adjustment

You may have seen the CMS 2027 Advance Notice regarding changes to risk adjustment stemming from in-home assessments and retrospective chart reviews.

This could lead to a significant drop in revenue for health plans that don’t respond quickly. But there is an alternative to retrospective risk adjustment for Medicare Advantage that is safe from these CMS policy changes and can reduce the risk of violations during RADV audits.

Vatica Health’s prospective risk adjustment solution pairs expert clinical teams with cutting-edge technology to support physicians at the point of care. All risk adjustment diagnosis codes are tied to a patient encounter, enabling you to align with CMS’s 2027 requirements.

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Let’s talk about how you can start to capture more member data, improve outcomes and maintain compliance in as little as a month.

A prospective solution that offers more value

Vatica Health — together with Cozeva, our new merger partner — offers provider-centric solutions that enable health plans to capture more member data, foster greater payer-provider collaboration and advance value-based care enablement. By combining our highly trained clinical teams with Cozeva’s premier VBC platform, health plans can optimize member and financial outcomes at the point of care in a way that suits them best. And our solutions can be implemented well in advance of any new regulations in 2027.

“We’ve advocated that one of our other large payers in the community partner with Vatica so we can use the solution for more of our patients. We’d like to see all the payers in our marketplace use Vatica and look forward to leveraging Vatica as we transition to more value-based care. Our group is very appreciative of Vatica’s efforts, partnership and collaboration.”

— Richard Charles, MD, General Physician PC, New York

“Vatica has been a great resource with ICD-10 coding, helping us get to a level of specificity that most physicians don’t have the coding experience for.”

— Anthony Rizzo, DO, Family Medicine Physician, Mercyhealth

“Having this detail helps me to document and code as accurately as possible, which directly factors into capitation rates for these patients. Receiving appropriate capitation makes a big difference to my practice. And the incentive we receive for each completed Annual Wellness Visit has a huge impact on our financials.”

— Paul Linder, MD, Internal Medicine Physician, Paul G. Linder and Associates

Take the direct path to prospective risk adjustment

Want to learn more?

Some perspective on prospective risk adjustment

A prospective solution that offers more value

Vatica + Cozeva = value

Ensures compliance, reduces audit risk

Support for your providers

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