eBrief: Four Commercial Risk Adjustment Best Practices
Looking at the data released in the "Summary Report on Transitional Reinsurance Payments and Risk Adjustment Transfers
" by the Department of Health & Human Services (HHS) on June 30, 2015, 194 issuers had to make payments to their competitors in the individual market and 402 issuers had to do the same in the small group market.
Accurate risk scores can make or break health plans competing in this marketplace; however, by implementing a successful risk adjustment program health plans can move the needle.
As Commercial health plans continue to look for cost-effective risk adjustment programs they need to think strategically about how they can implement the right programs. to the right members. at the right time to achieve optimal results. To do this, CenseoHealth recommends four risk adjustment best practices for success in the Commercial market.
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