Qualified Health Plan Risk Adjustment Program

Like you, at Blue Cross VT, we focus on high-quality patient care. 

Our provider engagement consultants from the Qualified Health Plan (QHP) Risk Adjustment team works in partnership with primary care practices to reach this shared goal for our members.

Risk adjustment helps ensure that Qualified Health Plans and providers are paid appropriately for the level of care they provide, considering the health status of their patients. This methodology is regulated by the Department of Health and Human Services (HHS) using the Centers for Medicare and Medicaid Services (CMS) guidelines and standards.

Below you will find a list of resources for learning more about QHP Risk Adjustment and for use with managing your population health.

If you are a primary care practice and have any questions about how we can work in partnership, please contact the QHP Risk Adjustment Team at (802) 371-3540 or RiskAdjustment@bcbsvt.com.