RAeknir Health announced that CMS initiated the PY2024 RADV audits on August 28 across 590 contracts.

Most at-risk provider groups in Medicare Advantage are subcontracted to several health plans at once, and every plan sends its data differently; MMRs, MORs, MAO-004 files, and claims, in nonstandard formats on different timelines. Getting that data into one clean, reconciled place is the hard part, and it is what stands between these groups and doing risk adjustment at all. Fixing it has always been a bespoke build, priced as consulting, so smaller groups either overpay for platforms that assume a foundation they never had, or never fix it. RAeknir puts AI on exactly that problem. We use it to do the ETL; ingesting each plan's nonstandard files and reconciling them into a single point of truth. The compression is roughly an order of magnitude at every size, which is what lets the foundation, and the fundamentals on top of it, ship as affordable software instead of a consulting engagement. Then we run the basics that actually move performance. See the members who set the baseline first; the new-to-plan and new-to-Medicare members, and the sickest and dual-eligible members. Recapture the chronic conditions genuinely still present. Keep acutes from refreshing once resolved. Submit only what the record supports. Here is what the market misses; most of what the expensive suspecting and chart-review platforms recover on the back end is value that was only lost because the data was broken on the front end. Fix the foundation and do the basics, and most of that gap never opens. Accuracy is measured in both directions; we are as willing to take an unsupported condition off as to add a missed one. Every recognized condition walks back to the record that supports it. And we are paid a flat per-member-per-month fee, not a share of what we help you book, so our incentives sit on the right side of compliance. Real risk adjustment for the groups the industry priced out. Risk Adjustment, Illuminated.