Risk adjustment has traditionally happened downstream of the patient encounter, requiring health plans and providers to reconstruct the clinical picture through chart review, coding, queries, and retrospective reconciliation. What changes when that work moves upstream?

This session explores what happens when the clinical conversation creates a more complete, evidence-rich record at the point of care. Moving documentation integrity upstream could help health plans and providers substantiate diagnoses, reconcile risk, and identify care gaps earlier, while reducing the administrative work of recovering information after the fact. The discussion will examine the implications for payer-provider collaboration, human oversight, and what becomes possible when both sides start with a stronger clinical record.