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.
Risk Adjustment
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California Finds a Prescription to Make Health Insurance Premiums Equitable
January 1, 2001 | Program Result Report
In 1995 and 1996, the California Managed Risk Medical Insurance Board, Sacramento, Calif., developed a risk-adjustment mechanism that was applied to small employer group health insurance purchasers in the Health Insurance Plan of California (HIPC), the first statewide health insurance purchasing cooperative for small employers (three to 50 employees).
Coping with Risk Segmentation
February 1, 2003 | Issue Brief
Risk segmentation and the consequent wide variation in premiums create at least two kinds of problems. First, some high-risk people are not able to afford coverage. Second, the wide premium spread requires some people to pay much more than others for identical coverage.
Health Insurance Exchanges
January 1, 2009 | Report
This paper analyzes whether Congress can legislate a health insurance mandate and the potential legal challenges that might arise, given such a mandate.
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.
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.
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.
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.
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 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.