Risk Adjustment

Risk adjustment (RA) is key to financial sustainability and equitable resource allocation in health plans. The annual wellness visit (AWV), whether completed by a member's PCP or through an in-home assessment, offers an ideal opportunity to capture accurate RA codes.

Engagys supports the entire process of member engagement and AWV completion for accurate risk adjustment coding, including:

Targeting & Segmentation: Boost AWV completion by targeting the right population.

Workflow Optimization: Maximize results by refining each step of your workflow.

Call Center Training: Enhance member experience with agent training based on behavioral science.

Omnichannel Campaigns: Drive better outcomes with optimized channel, timing, and frequency strategies.

Client Results

  • Doubled the number of AWVs completed by members who had previously been ‘soft declines’
  • 6X increase in targeted members talking to an agent by changing staffing and redial rules 
  • 44% improvement in visits completed after training the call center on behavioral science techniques 
  • 52% increase in visits completed by adding a SMS text option 

Risk Adjustment Best Practices

Risk Adjustment Best Practices
Risk Adjustment Best Practices