ACA Risk Adjustment: A Competitive Advantage
With the Biden administration re-opening the ACA exchange and the impacts of COVID-19 on employment through 2020 and beyond, we want to address the impact of ACA risk adjustment. The expanding healthcare landscape under the ACA and the continuous shift to value-based care means effective risk adjustment is often the difference between profitability and losses […]
Medical Loss Ratio and COVID-19: Investment, Risk, and Looking through 2022
For payors, Medical Loss Ratio is down to a point of short-term crisis and long-term complication this year and next. However, there is a solution: payer investment in pre-encounter programs that drive quality and care.
A Look at 2018 Healthcare Trends: Leveraging Technology to Scale and Succeed
Here are the top 4 healthcare trends we see for 2018. Find out how the CVS and Aetna merger will impact the way healthcare entities operate moving forward, and why AI and machine learning will continue to be a hot topic.
Strategies for Different Patient Populations and Payment Models
One-size doesn't fit all when it comes to the underlying risk adjustment strategies health plans should pursue given the market(s) that they participate in.
Accurate Risk Adjustment Determines Health Plan Performance in ACA Marketplace
Greater emphasis on risk adjustment is needed in the ACA market to support plan viability, accurately establish premium prices, and withstand competitive pressures.
Tag: Affordable Care Act / ACA
The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010.