Case Study: Regional Health Insurer achieves 25% more completed provider alerts in 2022 with Veradigm

Regional Health Insurer secures Year over Year Success with Veradigm Risk Adjustment

Regional Health Insurer, a nearly century-old not-for-profit serving more than three million people in the Northeast, sought to further optimize an already effective Risk Adjustment program to achieve higher levels of care accuracy and provider engagement. They partnered with Veradigm, adopting Veradigm Risk Adjustment Analytics, Veradigm eChart Coder, Risk Mitigator, EDI Translate and the Veradigm Collaborate provider engagement platform, and committed to investing in people and processes alongside the vendor.

Veradigm implemented a coordinated people–products–process approach—led by dedicated provider engagement and continuous education—plus analytics and automated coding tools to close gaps and improve coding accuracy. The results were measurable: completed provider alerts grew from 12,402 in 2019 to 45,797 in 2022, exceeding the 2022 goal by 25%, with more accurate risk scores, clinician feedback, and scalable provider workflows that sustained year‑over‑year improvement.