Health Affairs April 19, 2023
On April 17, 2023, the U.S. Department of Health and Human Services (HHS) published the final 2024 Notice of Benefit Payment Parameters and related materials. The rule contains a wide-ranging set of provisions: a previous article focused on insurance market reforms and consumer assistance provisions, and a subsequent article will address proposed changes to marketplace operational standards and policies related to Advance Premium Tax Credits.
This piece summarizes provisions related to the individual and small group market risk adjustment programs. The final payment notice largely continues existing risk adjustment policies, but HHS did finalize some policy changes, which largely (though not entirely) mirror those in the proposed rule.
Risk Score Model Updates
The core of the ACA risk adjustment system...
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