About Gentry
Consulting
Risk adjustment programs are rarely built cleanly.
They evolve across systems, vendors, and regulatory cycles—often without a unified operational structure. Performance variability, audit exposure, and execution breakdowns typically emerge from the interaction of these components rather than any single failure.
Gentry Consulting exists to address these conditions at the program level.
Operation Perspective
The firm’s approach to risk adjustment is grounded in direct operating experience leading and executing large-scale program delivery across Medicare Advantage, ACA Marketplace, and Medicaid environments.
From 2006 through 2018, Mark Gentry led the design, implementation, and operation of risk adjustment programs across multiple health plans as the delivery lead within a consulting firm’s risk adjustment line of business. In that role, he was responsible for program execution across concurrent client engagements, often serving as the primary operational interface with the health plan.
Engagements ranged from early-stage programs reviewing tens of thousands of encounters per cycle to fully scaled operations exceeding 100,000 chart reviews annually, delivered through a hybrid model of on-site provider engagement and remote abstraction. This work required building program infrastructure from the ground up, including:
medical record acquisition and digitization workflows
distributed review and coding operations
program-level coordination across providers, coders, and client teams
QA, audit-response, and reporting structures
At the time, available platforms provided limited operational capability, requiring execution models, tooling, and workflows to be developed independently to support program delivery at scale.
What This Experience Establishes
Across these programs, a consistent pattern emerged:
Risk adjustment performance is not driven by coding activity alone. It reflects show the entire program operates—across documentation, workflows, vendors, data systems, and execution discipline.
Breakdowns are rarely isolated. They are systemic.
These conditions were observed across multiple plan types, markets, and regulatory environments, including the transition from early Medicare Advantage models through ACA Marketplace implementation and state-specific Medicaid risk adjustment models.
Continuity of Practice
This experience spans multiple generations of risk adjustment models and operating environments, from early paper-based workflows and limited system infrastructure through EMR-driven programs and successive CMS and HHS model transitions.
Following the conclusion of large-scale delivery work, Gentry Consulting continued to support health plans and consulting firms across managed care operations, regulatory execution, and program oversight. Risk adjustment remained a core component of these engagements due to its direct impact on revenue accuracy and audit exposure.
The current environment reflects an extension of conditions observed repeatedly over time, rather than a departure from them.
Gentry Consulting operates as a senior-led advisory practice focused on risk adjustment as a program-level issue.
Engagements are structured to:
assess program stability and performance conditions
identify execution gaps and audit exposure
provide ongoing oversight, coordination, and decision support
This structure reflects how risk adjustment programs operate in practice and aligns with how they must be managed when performance or defensibility becomes material.
Current Engagement Model
Scope and Context
While the firm leads externally with risk adjustment, this work has been performed alongside broader managed care operations, including plan stand-up, regulatory submissions, operational readiness, and program leadership across Medicare Advantage, ACA Marketplace, and Medicaid environments.
These capabilities remain active within engagements where program conditions require expansion beyond risk adjustment alone.
Gentry Consulting is built on direct experience operating risk adjustment programs under real conditions—across scale, regulatory change, and execution complexity.
The firm’s engagement model reflects that experience.
Where risk adjustment becomes a program-level issue, engagement typically begins with a structured assessment.
Learn more about the Program Stability Diagnostic →