Risk Adjustment

The panel debated whether medically complex patients should be excluded or retained and handled through risk adjustment. Risk-adjustment models require empirical testing because existing tools may miss behavioral, social, and clinical complexity. Risk adjustment was discussed but deferred for later statistical model development. The final approach generally retained complex patients and planned to address heterogeneity through risk adjustment. Existing risk-adjustment tools may not capture social complexity, behavioral health factors, or certain clinical complexities adequately.