Medicare AdvantageDocumentationMedium impact
Risk Adjustment Program for PCPs Underway
EmblemHealth·NY · Family Medicine, Internal Medicine, General Practice·Provider News
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
EmblemHealth's 2025 Risk Adjustment Program for Primary Care Providers is now active through December 31, 2025, requiring PCPs to identify and properly document chronic conditions for NY State of Health, Medicare Advantage HMO, and Medicaid members. PCPs can receive additional reimbursement by completing provider alerts and submitting progress notes through Veradigm's Collaborate portal.
Action Required
By December 31, 2025: Primary care providers must maintain accurate medical records and claims coding to capture complete health status of EmblemHealth members with chronic conditions. Access Veradigm's Collaborate portal via emblemhealth.com/providerportal to complete provider alerts and submit progress notes for additional reimbursement. Consider attending free monthly 60-minute webinars for risk adjustment best practices.