CMS 2027 Final Rule: what you need to know

April 21, 2026

CMS 2027 Final Rule: what you need to know

Health plan

Risk adjustment

CMS released the 2027 Final Rule on April 6, 2026. Many of the key changes proposed in the Advance Notice appear in the final notice, with a few key exceptions.

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Case study

Relieve the burden of coding and documentation

Provider members of the Kentucky Primary Care Clinically Integrated Network found support in the Vatica program at no cost. Vatica relieved the burden of coding and documentation while generating additional health plan compensation. Read our case study for the noteworthy results.

Relieve the burden of coding and documentation with Vatica

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Key metrics for value-based care

Value-based care (VBC) is designed to incentivize providers to improve outcomes in a cost-efficient manner. In other words, payment and quality of care are inextricably linked.

What’s behind the move from retrospective to prospective risk adjustment?

Health plans across the country are recognizing the superior value of prospective risk adjustment programs, and rightfully so.

Another blow to detached health risk assessments

Health Affairs recently published a study of data from 4 million Medicare Advantage (MA) members indicating that health risk assessments (HRAs) contributed up to $12 billion per year to risk adjusted payments in 2020.

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Adjust your approach to risk adjustment

Talk to one of our risk adjustment experts today to see how we can help you deliver better performance and stronger compliance while closing gaps in care.

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