Which statement best describes how risk adjustment affects performance targets in MA and MIPS?

• A. It adjusts targets based on patient risk to ensure fairness.
• B. It eliminates the need for quality measures.
• C. It raises all targets for all patients.
• D. It lowers targets only for high-cost patients.

Answer: (A)

Risk adjustment levels the playing field by tailoring performance targets to the health risk of the patient mix a clinician or organization serves. In MA and MIPS, adjusting the benchmarks based on patient risk means providers aren’t unfairly penalized if they care for sicker or more complex patients—their expected outcomes and benchmarks shift to reflect that reality. This makes performance comparisons more meaningful and fair, focusing on quality of care rather than just patient complexity.

The other statements don’t fit because risk adjustment doesn’t eliminate quality measures, it doesn’t automatically raise targets for everyone, and it isn’t about lowering targets only for high-cost patients. It’s about adjusting the targets to align with the risk profile of the patient population.