Commercial Risk Adjustment

As the nation transitions to ICD-10 coding on October 1, 2015, health plans and physicians continue to express concerns that it will take time to adapt to the new version of codes. ICD-10 codes, which provide greater specificity to better represent and communicate a patient’s clinical conditions, in...
When HHS released their summary report on reinsurance payments and risk adjustment transfers on June 30, 2015, it became apparent just how important accurate risk scores are to the financial sustainability of health insurance plans that are subject to commercial risk adjustment.

Conference Recaps: Health Insurance Exchanges Are More Than a Buzzword

Posted on: Nov 25, 2013 | Authored By: Alanna Stage, Editor
From California to Massachusetts, the conversation at two recent national meetings swirled around the health insurance exchanges, and the reality of enrollment, marketing, funding and risk adjustment that comes with them.
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