Observational Intensity Bias Associated With Illness Adjustment
February 21, 2013 | Journal Article
Researchers raise significant questions about the risk adjustment that Medicare and others apply to insurance claims data.
Risk Adjustment
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Risk Adjustment in Health Insurance
August 30, 2012 | Issue Brief
Insurance market reforms under the Affordable Care Act (ACA) are designed to increase the number of Americans with insurance—and to shed the current system in which health plans have an incentive to enroll healthier people while avoiding the sick. O ...
Risk Adjustment and Reinsurance
December 1, 2011 | Issue Brief
This brief presents states with a work plan that outlines the decisions and actions needed to implement the risk adjustment and reinsurance provisions of the Affordable Care Act.
Risk Adjustment and Reinsurance
December 1, 2011 | Issue Brief
Under the Affordable Care Act (ACA) much of the expanded coverage will be provided through health insurers offering products on the new health insurance exchanges. To ensure robust markets, exchanges must have in place processes for mitigating the f ...
Insurance Discrimination On the Basis Of Health Status
January 1, 2009 | Report
This paper provides a brief overview of discrimination practices, the federal law and federal reform options to manage discriminatory practices in the insurance and employee health benefit markets.
Mitigating Risk in a State Health Insurance Exchange
December 1, 2011 | Toolkit
This toolkit series, released by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation, provides examples, templates, and lessons from Massachusetts.
Analysis of HHS Proposed Rules on Reinsurance, Risk Corridors and Risk Adjustment
September 1, 2011 | Issue Brief
Provisions critical to the successful implementation of ACA.
Methods of Mortality Risk Adjustment in the NICU
March 1, 2013 | Journal Article
NICU mortality risk-adjustment scores vary widely by the data collected and the timing of collection.
Health Risk Appraisals
September 1, 2009 | Journal Article
Risk appraisals might influence employees' health behavior, but they're not the entire answer. In this paper the authors explore the potential role of health risk appraisals as a tool for managing health care quality and costs in employer-sponsored insurance.
Risk Selection and Risk Adjustment
June 1, 2009 | Journal Article
This article describes underlying problems in the markets for small group and individual insurance appraises current methods of subsidizing insurance for high-risk individuals and discusses how risk adjustment addresses conflicts between the group and individual insurance markets.