Modern Healthcare June 28, 2019
Shelby Livingston

The CMS released data on Friday showing the results of a program meant to stabilize insurance premiums in the Affordable Care Act insurance markets.

Now in its fifth year, the permanent risk-adjustment program shuffles money from plans that enroll relatively healthy members to plans that enrolled sicker ones. The goal is reduce the incentive for plans to cherry-pick healthy members, and the CMS said it’s working as it should.

The agency said 572 health insurers participated in the zero-sum program for the 2018 benefit year, and transfers between the companies totaled $10.4 billion—$5.2 billion in payments and $5.2 billion in charges. The agency included insurer-level payments and charges in its report.

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Topics: ACA (Affordable Care Act), CMS, Govt Agencies, Health System / Hospital, Insurance, Patient / Consumer, Payer, Physician, Primary care, Provider, Public Exchange
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