Why Smart Health Plans Keep Risk Scoring In-House
Every time your organization ships PHI to a third-party risk adjustment vendor, you expand your attack surface. What feels like a routine data exchange is actually a high-value vulnerability—one that sophisticated health plans and ACOs are actively eliminating.
“ Why are we sending our most sensitive data off-site to run calculations we could control ourselves? ”
The Hidden Security Tax of Vendor Scoring
When risk scoring relies on external APIs or cloud vendors, the cost isn’t just financial—it’s operational risk.
Each new vendor relationship multiplies your exposure across:
BAA complexity
Every contract introduces legal and operational overhead.
Audit exposure
More third parties mean more systems to validate under CMS and RADV scrutiny.
Compliance risk
Even if a vendor mishandles PHI, your organization is still accountable.
IT overhead
Vendor risk assessments, SOC reviews, and ongoing monitoring drain finite resources.
For many regional health plans, this “security tax” exceeds the actual software subscription itself.
The Local Control Alternative
Risk scoring doesn’t require external dependencies. With the right tools, your data science or IT team can run CMS-HCC models locally, keeping PHI inside your environment at all times.
The security and governance advantages are immediate:
Zero PHI exposure
No data ever leaves your servers.
No BAAs required
Core analytics stay under your control.
Audit readiness
Transparent, reproducible scoring logic builds a defensible posture.
Complete control
Your standards, your infrastructure, your timeline.
Security Without Sacrifice
Modern Python-based scoring solutions like MSCORE® deliver the same CMS-HCC accuracy that vendors promise—but without the external dependency. Instead of transmitting patient data to a black-box API, your team executes official CMS logic locally. That shift eliminates your most significant data exfiltration risk while empowering IT to align security, compliance, and analytics on your terms.
Operational Independence for CISOs
This isn’t just a technical upgrade. It’s a strategic shift that strengthens your entire security architecture:
- No vendor outages dictating your risk analytics.
- No lock-in contracts holding critical infrastructure hostage.
- No misalignment between compliance obligations and vendor practices.
Instead, risk scoring becomes a controlled, auditable, internally owned process—one that reduces your liability while improving organizational agility.
The CISO’s Question
In an era of escalating healthcare breaches and intensifying audits, every CISO should be asking: Why are we exposing our most sensitive data to solve a problem we can solve internally?
With MSCORE®, you can eliminate PHI exposure while retaining full control, transparency, and speed.
Discover how MSCORE® can transform your risk adjustment process