In today’s value-based landscape, accurate risk adjustment isn’t just a compliance requirement—it’s a competitive advantage. The Edifecs Risk Optimization Toolkit equips health plans and provider organizations with a proven framework to strengthen risk capture, enhance care outcomes, and safeguard revenue integrity.
Built for organizations at every stage of risk maturity—from early upside-only arrangements to advanced, tech-enabled programs—the toolkit delivers actionable insights grounded in performance metrics that matter. Learn how industry leaders achieve best-in-class recapture rates, boost Comprehensive Care Visit (CCV) documentation, and leverage Annual Wellness Visits to close gaps and elevate RAF scores.

This isn’t theory—it’s strategy. Inside, you’ll find guidance on structuring universal workflows, applying AI and NLP to unstructured data, and building a more resilient coding infrastructure that supports both prospective and retrospective review. From streamlining FHIR-based chart retrieval to scaling clinical review capacity without increasing headcount, the toolkit shows how the right data and workflows power smarter decision-making across the organization.
And because Edifecs understands that technology should amplify—not replace—clinical expertise, this toolkit emphasizes the synergy between people and platforms. Whether you’re optimizing coding throughput, centralizing insights across lines of business, or preparing for CMS audits, this resource helps you move forward with confidence.

Edifecs empowers organizations to go beyond the baseline and build risk adjustment programs that are scalable, compliant, and clinically aligned.

Access the Risk Optimization Toolkit and discover how to turn risk adjustment into a strategic driver of value-based care.