risk adjustment models

Risk adjustment models are tools used to account for differences in patient health when comparing healthcare outcomes or costs. They analyze factors like age, health conditions, and medical history to predict expected healthcare needs, ensuring that providers or plans are evaluated fairly. For example, a hospital treating sicker patients might seem to perform worse without risk adjustment, so these models help to make fair comparisons by considering patient complexity. Essentially, they level the playing field, allowing for more accurate assessments of quality and efficiency across different healthcare providers.