Case Study

Episource’s Risk Program Assessment Delivers Personalized Insights and Identifies RAF Opportunities


DID YOU KNOW? 20% of members in a given population aren’t accurately risk adjusted? Additionally, payers miss approximately 30% of their reimbursement value.

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casestudy_Program Assessment Delivers Personalized Insights and Identifies RAF Opportunities

Out of over 400,000 members across various plan types, we found that between 7% and 14% of members had no date of service in a particular year. Further, HCC recapture rates were sometimes as low as 41%—pointing to significant performance improvement opportunities.

Download the case study to learn how you can improve your risk adjustment program performance to optimize financial and clinical outcomes today.

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