CMS issued a final rule to continue its risk adjustment program for the 2018 benefit year. 1. The risk adjustment program was established under the ACA to encourage insurers to participate in the ...

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.

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 ...

Connecticut Insurance Commissioner Katharine L. Wade moved to protect existing policyholders after HealthyCT learned June 30, 2016, it would have to pay CMS $13.4 million under the ACA Risk Adjustment ...

HHS sets the risk adjustment methodology that it uses in states that elect not to operate the program in advance of each benefit year through a notice-and-comment rulemaking process with the intention ...