Risk Adjustment: Why It’s Foundational in Value-Based Payment Models

Persivia Inc12 Jul, 2025Health

The way insurance companies compensate physicians is starting to change. When physicians treat patients who are more ill, risk adjustment helps them be compensated fairly. Doctors with healthy patients shouldn’t get the same payment as doctors treating diabetes and heart disease. Risk Adjustment is a payment calculation method that accounts for patient health differences. It uses diagnosis codes and patient demographics to predict future healthcare costs.