Episode 57: Risk Adjustment with Lisa Purnell

In this episode of For the Love of Revenue Cycle, host Vanessa Moldovan interviews Lisa Purnell, Director of Risk Adjustment at Community Health Choice in Houston. Lisa explains risk adjustment as measuring population sickness to predict future costs, centered on accurate diagnosis coding and documentation that supports patient complexity and resource needs. She describes how risk adjustment affects many health plan departments, why revenue cycle teams often misunderstand it, and how it informs premiums and care management. 00:00 Welcome and Big News 00:14 AI Playbook Announcement 01:14 Episode Topic Risk Adjustment 02:18 Meet Lisa Purnell 03:35 Lisa's Path to Risk 05:30 Risk Adjustment Explained 06:48 Who Benefits and How 10:13 Why Rev Cycle Misses It 13:45 Outpatient vs Inpatient 15:50 Documentation Storytelling 17:49 January 1 Reset Myth 20:54 Compliance Guardrails 23:40 Why It Matters Now 25:04 Action Steps to Start 27:35 Marketplace and Risk Scores 29:50 Final Takeaways and Wrap 31:31 Outro and Contact Info