Why some issuers hate the ACA risk-adjustment program
Court rulings permitting, the Blues could get $2.3 billion. Kaiser, Centene and Molina could pay $2 billion.
By Allison Bell|July 16, 2018 at 10:01 AM
Thank you for sharing!
Your article was successfully shared with the contacts you provided.
Officials at the Centers for Medicare and Medicaid Services have started a new round of insurer-on-insurer wrestling, by posting preliminary Affordable Care Act risk-adjustment program figures for 2017.
The program is supposed to use cash from the health insurers that end up with healthier-than-average individual and small-group enrollees to compensate the insurers that end up with sicker-than-average enrollees. The program could shift about $3.8 billion of the $75 billion in 2017 individual major medical premium revenue that’s part of the program from one carrier to another, as well as $1.3 billion of the $52 billion in small-group revenue that’s part of the program.
Complete your profile to continue reading and get FREE access to BenefitsPRO.com, part of your ALM digital membership.
Your access to unlimited BenefitsPRO.com content isn’t changing. Once you are an ALM digital member, you’ll receive:
Critical BenefitsPRO.com information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events.
Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com