Federal regulators will need to modify the Affordable Care Act (ACA) risk adjustment program if policymakers make changes to the individual and small group health insurance markets, according to a new ...

Ramping up the controversy surrounding the Affordable Care Act’s risk adjustment program, two more health insurers have sued the federal government over what they see is a flawed formula that unfairly ...

Newly finalized regulations from the federal government create a “next generation risk adjustment model” aimed at stabilizing the Affordable Care Act marketplaces. On Friday, the Centers for Medicare ...

Worcester-based Fallon Health and two other insurance plans have asked the state’s Health Connector Insurance Authority to review risk assessment fees that they say could financially impact smaller ...

In future rulemaking, the Centers for Medicare and Medicaid Services will propose that all issuers fund a small payment to the risk adjustment program to help marketplace insurers with high claims ...

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.

For health plans serving the individual market, the Affordable Care Act’s risk adjustment program generally worked as intended to shift funds from insurers with low-cost enrollees to plans with ...