A few weeks ago, we were critical of the Trump administration’s handling of ACA risk adjustment payments. We’re fair-minded types around here, so we though
It took a crisis to spur the Trump administration to action, but it did finally act. Yesterday evening, HHS released a rule addressing a New
The Trump administration announced its intent to stop making risk adjustment payments to insurers on the ACA marketplaces. Just… watch. @aaronecarroll
On Friday evening, the Wall Street Journal reported that the Trump administration would be suspending risk adjustment payments due for 2017 and 2018. The next
If you’re one of the six people left who still hasn’t had enough of ACA litigation, you’re in luck. Yesterday, a health plan in Maryland
Below are links to three new papers on risk adjustment in the ACA Marketplaces. I have not read them in full, but intend to. This
Can we all calm down about death spirals? Yes, recent HealthCare.gov news has been dismal at best. Yes, the administration is statutorily locked in to the open enrollment
The underlying assumption is that patients that are coded as sicker in claims and administrative data are always, in fact, sicker. That assumption is wrong.
We analyzed utilization patterns of enrollees in Medicare Advantage health maintenance organization (HMO) plans compared to matched samples of people in traditional Medicare during 2003–09,
I’ve fixed my earlier post on competitive risk adjustment. Mistakes happen and I had a whopper in it. But that’s gone now and explained tersely
One of the key concerns about private plans participating in Medicare (or private plans in general) is that they may “cream skim,” or establish benefits
The bomb at the center of health services research has detonated. It’s this: patterns of diagnosis do not simply reflect patient characteristics. They are, in
