The Centers for Medicare and Medicaid Services released a white paper detailing the Centers for Medicare and Medicaid’s risk adjustment model Thursday.
“CMS has implemented a risk adjustment program to mitigate the effects of risk selection on health insurance premiums for non-grandfathered plans in the individual and small group markets,” the paper concludes. “The risk adjustment program, supports market stability by pooling risk and transferring funds from plans with more low-risk (i.e., healthier and lower cost) enrollees to those plans with more high-risk (i.e., less healthy and higher cost) enrollees.”
The paper also suggests potential modifications for the 2018 and 2019 benefit years.
