Navigating Risk Adjustment in 2025: A Guide for Health Plans

Join Joe Boyle, President of Regulatory Solutions at Penstock, as he breaks down CMS’s risk adjustment and user fee updates for benefit year 2025. This episode is your go-to guide for navigating the evolving regulatory landscape.

Here’s What You’ll Learn:

• How CMS’s use of 2019–2021 data impacts 2025 submissions
• The role of the American Rescue Plan in shaping membership trends and user fees
• Key strategies for issuers entering new markets
• Tips for compliance when serving AI/AN populations
• Why predictive modeling is the future of risk adjustment

Whether you’re an established issuer or entering a new market, this episode is packed with actionable insights and practical recommendations to help you stay compliant, optimize processes, and prepare for the future of risk adjustment.

🎧 Listen now and make sure your team is ready for the 2025 submission season. Subscribe to Regulatory Joe for updates on regulatory filing for health plans, compliance tips, and more.