Podcast: An innovation roadmap for risk adjustment strategies

New dynamics in risk adjustment are prompting health plans to rethink their strategies for 2026 and beyond. With regulatory changes and evolving audit methodologies on the horizon, health plans are investing in prospective and concurrent approaches alongside their traditional retrospective programs to help ensure sustainability, improve coding accuracy, and strengthen compliance.

In a new episode of the RISE Radio podcast, senior leaders from Cotiviti and Edifecs offer strategies for building scalable risk adjustment technology initiatives while navigating rising business and regulatory pressures. 

Listen to the podcast featuring Branka Sustic, Cotiviti vice president of risk adjustment and quality, and Summerpal Kahlon, M.D., Edifecs chief medical officer, to learn more about:

• How to enhance data accuracy
• How to align tech investments with measurable impact
• How to build integrated risk adjustment strategies and better healthcare enablement

You’ll also learn more about how the combined strengths of Cotiviti and Edifecs are powering the next wave of innovation along the full risk adjustment lifecycle. Don’t miss this opportunity to stay ahead as prospective and concurrent risk adjustment become increasingly vital to success.

For more information on structuring your plan for risk adjustment success in the new year and beyond, read our new checklist on how to create a comprehensive risk adjustment program. You’ll learn a concrete action plan framework for both short- and long-term success along with critical KPIs to track and improve impact.

Branka Sustic, M.S. Vice President of Risk Adjustment and Quality, Cotiviti Branka provides leadership in product and business development, client program management, and strategy to assist health plans in meeting their quality goals, optimization of revenue, and risk mitigation. A leader with more than 20 years of healthcare experience, she is known for creating and establishing operational and support plans leading to increased client satisfaction and performance.

Summerpal Kahlon, M.D. Chief Medical Officer, Edifecs Dr. Kahlon works across products and functions to guide clinical strategies and policies. His career spans over 20 years of experience in diverse health care settings, businesses, and markets. Dr. Kahlon has deep expertise in value-based care and risk adjustment, and brings unique insight to help customers make the most comprehensive, informed, and clinically relevant decisions for their populations. He is a practicing physician with Veterans Affairs and an assistant professor of internal medicine at the University of Central Florida.