Transcription of Risk Adjustment Methodology Overview - CMS
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Risk Adjustment Methodology Overview - CMS
Risk Adjustment Methodology Overview DEPARTMENT OF HEALTH AND HUMAN SERVICES. CENTERS for MEDICARE & MEDICAID SERVICES. Center for Consumer Information and Insurance Oversight Health Insurance Exchange System-Wide Meeting May 21-23, 2012. Contents Background HHS-developed risk Adjustment Methodology Risk Adjustment model Payment transfers State alternate methodologies Note: see also presentations at : #fm 2. CONTEXT. The contents of this presentation represent preliminary information with the purpose of soliciting stakeholder feedback. Draft policies for the risk Adjustment program will be announced in the draft HHS notice of benefit and payment parameters, which will be subject to comment before finalized.
receive ACA transitional reinsurance payments for the same high risk enrollees. Adjusting for transitional reinsurance payments would address concerns that a plan could be compensated twice for the same high -risk individuals • HHS is inclined to propose not to adjust for transitional reinsurance payments
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