Featured articleRADV / Audit Readiness
The End of Revenue-First Risk Adjustment
Part I: Why Defensibility Is Now the Only Strategy That Matters
April 7, 20268 min read
By Vicky Mahn-DiNicola, RN, MS — Co-Founder and Clinical Principal, The Numeracy Group
Why this matters
RADV expansion, growing enforcement, and documentation-driven liability are changing risk adjustment from a revenue-first function to a defensibility-first operating model.
This article outlines why unsupported diagnoses now create material financial and audit risk, why legacy “capture more conditions” thinking is no longer sufficient, and why defensibility must become the new standard for risk adjustment strategy.