• A solution to a nearly ubiquitous problem with risk adjustment

    The underlying assumption is that patients that are coded as sicker in claims and administrative data are always, in fact, sicker. That assumption is wrong. The bad news is that a lot of research, performance measures, and plan payments are, therefore, biased. The good news is that we now have a way of addressing the problem. For more, read my latest at the AcademyHealth blog.


    • It was clear to me if this was forward looking data? Has such research been done with these risk adjustment models?

    • My immediate thought was to wonder if we will get an observer effect. Is there some way the insurance companies or providers can game this if they know they are being watched?