ACOs entering MSSP with higher spending were consistently more likely to earn bonuses—a gap that persisted after a 2017 ...

The Medicare Shared Savings Program (MSSP) adjusts savings benchmarks by beneficiaries’ baseline risk scores. To discourage increased coding intensity, the benchmark is not adjusted upward if ...

On December 31, 2019, a three-judge panel of the Tenth Circuit Court of Appeals upheld the methodology adopted by the Department of Health and Human Services (HHS) to administer the risk adjustment ...

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 ...

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 ...

Leavitt Partners: What major insurers have to say about CMS’ risk adjustment program The Patient Protection and Affordable Care Act (ACA) introduced restrictions on underwriting and new federal ...

In a new final rule, CMS reissued the Affordable Care Act's risk adjustment program for payers in the ACA exchanges for the 2018 benefit year. The reissue includes an additional explanation of the ...

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The Trump administration announced Saturday that it will temporarily halt billions of dollars in payments under the Affordable Care Act’s risk adjustment program, a move that could shake up insurance ...

Commercial health plan initiation of a co-pay accumulator adjustment program for specialty medications treating autoimmune diseases was associated with significant reductions in medication adherence ...