Provider guide to MA and ACA risk adjustment now available

Blue Cross and Blue Shield of Kansas (BCBSKS) has published a risk adjustment provider guide to Medicare Advantage and ACA risk adjustment resource on our website. This resource explains the fundamentals of risk adjustment, a payment model used by the Centers for Medicare & Medicaid Services (CMS) to predict future health care costs and ensure fair, accurate payments across health plans.

The guide outlines:

• What risk adjustment is and why it matters – including how it helps promote equitable access to care and supports accurate forecasting of patient health needs.
• How providers play a key role – through accurate diagnosis coding, comprehensive medical documentation and complete patient assessments.
• Best practices and frequently asked questions – offering practical tips to support accurate reporting through documentation and coding.

Understanding and applying effective risk adjustment practices helps ensure that patients with complex or chronic conditions receive the care they need, while also strengthening data accuracy for your practice.

For any questions, please contact our Risk Adjustment team at [email protected]. Thank you for your continued partnership and commitment to quality patient care.