Ramping up the controversy surrounding the Affordable Care Act’s risk adjustment program, two more health insurers have sued the federal government over what they see is a flawed formula that unfairly ...

In its first year, the Affordable Care Act's risk adjustment program helped control costs for insurance companies with high-risk enrollees, but several modifications could improve the program's ...

On June 30, the Centers for Medicare and Medicaid Services (CMS) released its report on the Affordable Care Act’s (ACA) risk-adjustment and reinsurance programs for benefit year 2015. Less than a week ...

On December 31, 2019, a three-judge panel of the Tenth Circuit Court of Appeals upheld the methodology adopted by the Department of Health and Human Services (HHS) to administer the risk adjustment ...

To maximize shared savings, mastering risk adjustment is a critical factor for Accountable Care Organizations (ACOs) participating in MSSP, ACO REACH, and other alternative payment models.

For health plans serving the individual market, the Affordable Care Act’s risk adjustment program generally worked as intended to shift funds from insurers with low-cost enrollees to plans with ...

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