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Medicaid Risk Adjustment

Optum has the expertise, breadth and scale to help optimize and support your Medicaid risk and quality programs.


Report more accurate health status

States differ in their individual Medicaid risk adjustment regulations, reimbursements and penalties. It can be a challenge for health plans to stay current with the ongoing changes.

Our dedicated informatics and actuarial experts support the most common state Medicaid risk adjustment models. We take a holistic approach to work across your managed Medicaid markets. We identify opportunities to help:

  • Maximize the potential of your risk adjustment strategy
  • Engage providers and members
  • Report a more accurate and complete picture of your Medicaid member health status

Get a real-time cost-benefit analysis

Through our advanced analytics, Optum can model a real-time cost-benefit analysis as part of our initial conversation with you. That means you’ll understand the value we can deliver for your health plan before you sign the contract.

Request a cost-benefit analysis today

See how Optum can drive better risk and quality outcomes for members, health plans and providers.