Clearwater, FL – December 2025 – MHC Services Group has released a new white paper designed to help Medicare Advantage organizations navigate the sweeping changes introduced by the CMS-HCC V28 risk adjustment model. Titled “Medicare Advantage Risk Adjustment Modernization: Preparing for CMS-HCC Model V28,” the paper breaks down what has changed, why it matters, and the modernization steps plans must take to maintain accuracy and financial stability through the transition.
The shift to V28 represents the most significant risk adjustment overhaul in more than a decade. New diagnostic hierarchies, recalibrated coefficients, and blended model years through 2025 mean that many existing workflows, data pipelines, and reporting structures were not built for the level of precision V28 now demands. As a result, plans are confronting increased scrutiny around documentation, compliance, and forecasting — often without the operational alignment required to respond effectively.
“V28 isn’t just a technical update – it’s an operational transformation,” said Ronny Neira, Partner and Chief Services Officer at MHC Services Group. “Plans must align data, compliance, finance, and actuarial teams to ensure the accuracy and confidence that the new model requires.”
The white paper highlights the core areas where health plans must focus to achieve V28 readiness:
- Model Understanding and Impact Analysis – Clear guidance on how V28 reshapes diagnostic categories, hierarchy logic, and financial projections.
- Data Pipeline and Warehouse Alignment – Ensuring mappings, reporting structures, and QA frameworks support parallel accuracy across both V24 and V28.
- Compliance and Documentation Integrity – Addressing controls required to reduce risk in blended years and beyond.
- Modernization Roadmap – Practical steps plans can take to strengthen forecasting, improve operational resilience, and prepare for long-term regulatory expectations.
MHC’s two decades of experience supporting healthcare organizations with system implementations, data modernization, and operational alignment inform the paper’s recommendations. The firm has partnered with Medicare Advantage plans nationwide to rebuild data workflows, validate risk models, and deliver the clarity needed for executive decision-making.
The white paper is available for download here.
About MHC Services Group
MHC Services Group helps healthcare payers simplify operations and modernize data processes through purpose-built technology and expert implementation support. With deep experience across risk adjustment, analytics, and IT strategy, the firm ensures that payers can adapt to regulatory change while achieving measurable business results.
Media Contact:
Name: Carol Brown
Title: VP Marketing
Email: carol.brown@mhcsg.com
Phone: 520.401.7336
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www.mhcsg.com