AHIP asks feds to consider risk adjustment program changes

America's Health Insurance Plans is urging the Centers for Medicare & Medicaid Services to consider making "targeted changes" to improve the risk adjustment model it uses to stabilize the Affordable Care Act marketplaces. In a letter sent this week to the agency, AHIP calls for CMS to: adopt a durational factor into the risk-adjustment model to better capture the risk of partial year enrollment; Support the inclusion of prescription drug data to improve payment accuracy under the risk adjustment model; and not go forward with the high-risk pooling approach described in the agency's recent discussion paper, among other commments and recommendations. Letter (.pdf)

Suggested Articles

The Trump administration has finalized a rule that will require private insurers to launch price transparency tools for members.

Teladoc's virtual care business is booming and the pending acquisition of Livongo will only increase the company's value proposition, executives say.

CMS announced it will offer the COVID-19 vaccine to Medicare beneficiaries at no cost to patients and issued new add-on payments for virus treatments.