--- title: One Way Health Plans Can Execute Risk Adjustment for a Better ROI description: How can health plans respond nimbly to industry changes and partner their risk adjustment strategy with quality and care management efforts? image: https://insights.vitaldatatechnology.com/hubfs/Artboard%202.png --- [![Vital Data Technology Logo](https://insights.vitaldatatechnology.com/hs-fs/hubfs/VitalData_Main%20Logo.png?width=2793&height=595&name=VitalData_Main%20Logo.png "Vital Data Technology Logo")](https://vitaldatatechnology.com/) - [Home](https://vitaldatatechnology.com/) - [Solutions](https://vitaldatatechnology.com/solutions/) - Affinitē Clinical Workflows - [Care Management (CM)](https://vitaldatatechnology.com/care-management/) - [Utilization Management (UM)](https://vitaldatatechnology.com/utilization-management/) - [Affinitē Benefit Query Engine (BQE)](https://vitaldatatechnology.com/benefit-query-engine/) - [Quality Improvement (QI)](https://vitaldatatechnology.com/quality-improvement/) - [Appeals & Grievances (AG)](https://vitaldatatechnology.com/appeals-grievances/) - [Affinitē Intelligent Insights](https://vitaldatatechnology.com/intelligent-insights/) - [Predictive Insights](https://vitaldatatechnology.com/predictive-insights/) - [Population Health Analytics](https://vitaldatatechnology.com/population-health-analytics/) - [Care Gap Analytics](https://vitaldatatechnology.com/care-gap-analytics/) - [Risk Analytics](https://vitaldatatechnology.com/risk-analytics/) - [Affinitē Platform](https://vitaldatatechnology.com/affinite-platform/) - [Analytics + Execution](https://vitaldatatechnology.com/analytics-plus-execution/) - [Intelligent Automation](https://vitaldatatechnology.com/intelligent-automation/) - [Health Data Management](https://vitaldatatechnology.com/health-data-management/) - [Member and Provider Engagement](https://vitaldatatechnology.com/provider-member-engagement/) - [Who We Serve](https://vitaldatatechnology.com/who-we-serve/) - Company - [About Us](https://vitaldatatechnology.com/about-us/) - [Careers](https://vitaldatatechnology.com/careers/) - [Privacy Policy](https://vitaldatatechnology.com/privacy-policy/) - [Resources](https://vitaldatatechnology.com/resources/) - [Blog](https://insights.vitaldatatechnology.com/) - [Videos](https://vitaldatatechnology.com/videos/) - [Solution Briefs](https://vitaldatatechnology.com/solution-briefs/) - [Contact Us](https://vitaldatatechnology.com/contact-us/) [May 4, 2021](https://insights.vitaldatatechnology.com/author/vital-data-technology) [Industry Insight](https://insights.vitaldatatechnology.com/tag/industry-insight), [Risk Adjustment](https://insights.vitaldatatechnology.com/tag/risk-adjustment) # One Way Health Plans Can Execute Risk Adjustment for a Better ROI ![Artboard 2](https://insights.vitaldatatechnology.com/hs-fs/hubfs/Artboard%202.png?width=417&name=Artboard%202.png) As a health plan, measuring the efficiency of your risk adjustment initiatives is a leading indicator for which programs are most effective. Vendors may offer an acceptable return on investment on their services, but their program ROI is unlikely to improve over time. This is especially true when the vendor’s services are tied to volume. The vendor will be incentivized to provide a volume of service that may not be justified by suspecting logic. This additional work will provide marginally less value the more it is expanded. Services such as chart abstraction and in-home visits are particularly susceptible to this. > Ultimately, the best way to get the most out of a risk adjustment strategy is to bring it in-house. By bringing it under their own roof, health plans can establish the optimal volume based on budget or projected opportunity and can tightly control the level of work. On top of that, payers can avoid pressure from vendors to expand the work beyond a reasonable volume. Building the capacity and infrastructure to perform risk adjustment in-house is a significant investment. It takes a sizable workforce to conduct chart abstraction and to implement an in-home visit program. Building these programs is a long-term investment in which a significant cost will be incurred upfront. However, this investment will lead to more sustained value over time versus contracting with a vendor is more of a transaction, not an investment. It can provide immediate value, but that value is unlikely to grow. Bringing risk adjustment in house sustains value over time in three ways:  1. Health plans can respond more nimbly to changes in the healthcare and risk adjustment landscapes (changes that are pretty frequent) 2. Organizations can more readily pinpoint how each program’s value shifts over time, and resources can be more efficiently allocated to the programs that are driving greater value.  3. Health plans can coordinate internally with other parts of the business, such as care management and quality, to provide more comprehensive and cost-effective care for members.  In healthcare, it can be difficult to plan for and invest in the future when every year brings different financial challenges for health plans. However, the challenges will only increase over time. Plans that want to remain viable into the future should begin investing in the business to sustain ROI over time. [Talk to one of our risk adjustment experts today](https://vitaldatatechnologyllc.whosen.com/c/Anthony_Bustos) to learn more about how you can best execute an in-house risk adjustment strategy. Previous post [Data Science & Healthcare: Why Health Plans Need to Do Better with Data](https://insights.vitaldatatechnology.com/why-health-plans-need-to-do-better-with-data-science) Next post [How Healthcare Workflows Can Use Intelligent Automation for Better Care](https://insights.vitaldatatechnology.com/how-healthcare-workflows-can-use-intelligent-automation-for-better-care) ### Recent Posts - [Beyond Predictive Analytics: Why Health Plans Need an Operating Model for AI](https://insights.vitaldatatechnology.com/beyond-predictive-analytics-why-health-plans-need-an-operating-model-for-ai) - [Preparing for HEDIS® MY 2027: Five Trends Every Health Plan Should Be Planning for Now](https://insights.vitaldatatechnology.com/preparing-for-hedis-my-2027-five-trends-every-health-plan-should-be-planning-for-now) - [Vital Data Technology Achieves NCQA HEDIS® MY 2026 Certification](https://insights.vitaldatatechnology.com/vital-data-technology-achieves-ncqa-hedis-my-2026-certification) - [Beyond Silos: Why the Next Generation of Value-Based Care Depends on Integrating UM, Care Management, and Payment Integrity](https://insights.vitaldatatechnology.com/beyond-silos-why-the-next-generation-of-value-based-care-depends-on-integrating-um-care-management-and-payment-integrity) - 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