HIX Enrollment Closed, Risk Assignment Challenges Start

The Obama administration is boasting that 8 million Americans, including a good number of young people, have enrolled in public exchange plans. The big question now is how will new members fit into the risk adjustment puzzle?
Published Online: April 21, 2014
The Obama administration is boasting that 8 million Americans, including a good number of young people, have enrolled in public exchange plans. The big question now is how will new members fit into the risk adjustment puzzle?

Aside from collecting premiums — it’s still not known how many of the new enrollees have paid for the first month — many exchange insurers are now trying to learn as much as they can about new enrollees to start assigning them risk scores.

What is known is that in the 36 states with federally-managed exchanges, 28 percent of new plan buyers are between 18 and 34 years old — a bit less perhaps than what some may have hoped for, but probably enough to avert a premium “death spiral.”

Read the full story here: http://bit.ly/1nCzvuZ

Source: Healthcare Payer News



Feature
Recommended Articles
As co-pays and deductibles in Medicare and commercial health plans become more prevalent, so, too, does the temptation to waive them. But beware.
In addition to increasing insurance coverage, the Affordable Care Act also aims to improve population health and lower healthcare costs. However, not much attention has been paid to the quality of care the newly insured are receiving.
Cardiovascular disease may be the leading cause of death in the United States, but half of those deaths can be prevented, according to researchers from Emory’s Rollins School of Public Health.
During this one-on-one interview, a part of the Oncology Stakeholders Summit, Spring 2015 series, Michael Kolodziej, MD, discusses payer considerations regarding coverage for new cancer treatments such as immuno-oncology therapies.
A study published in Health Affairs has found that primary care physicians refer women Medicaid enrollees to fewer preventive services than do their counterparts with private insurance coverage.