ACA Risk Adjustment Toolkit
Read what industry pundits are saying about the July 7, 2018 announcement from CMS regarding halting ACA risk adjustment transfer payments and the implications for health plans.
Interested in learning more? Visit the documents tab of the recent Co-located: Government Programs AND Risk, Compliance, Privacy and Security Value Visit, which took place August 6-10, 2018 in San Francisco.
NOTE: You must login to your Alliance account to access the articles and resources below. Some content may only be accessible to Alliance members.
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Recording: Risk Adjustment Round Table 2020, Session 4: HHS RADV IVA Benchmarking Survey Results
Join us for a discussion of the results of the 3rd Annual Alliance HHS RADV IVA Benchmarking Survey! This year, 18 Alliance member health plans submitted data on their 2018 HHS RADV IVA. Engage in a lively discussion about the findings and the delay in the HHS RADV Audit.
2018 HHS RADV IVA Benchmarking Survey Results
Join us for a discussion of the results of the 3rd Annual Alliance HHS RADV IVA Benchmarking Survey! This year, 18 Alliance member health plans submitted data on their 2018 HHS RADV IVA. Engage in a lively discussion about the findings and the delay in the HHS RADV Audit.
Recording: Risk Adjustment Round Table 2020, Session 3: Org. Structures
A continuation of the February Risk Adjustment Fly-in session led by Jess Dupont, Health New England, on risk adjustment staffing and organizational structures.
Advantasure Updates_Regulatory Requirements and System Configuration_ 06.12.2020
Advantasure provides a comprehensive update on new regulations. This update includes guidance on how these regulations impact telehealth services and much more. Learn more about Advantasure by visiting our vendor directory.
Recording: Paramount Healthcare Case Study: Optimizing the Use of Risk Adjustment Vendors
Episource. LLC., presents a case study on Paramount Healthcare, a current Health Plan Alliance member, who did extensive research prior to deciding what Vendor Partner to choose for their Risk Adjustment solutions.
Telehealth and Communication Technology Based Services: CY 2019 Physician Fee Schedule
Presented by CMS at the 2019 American Telemedicine Association Annual Conference
CMS finalizes plan to continue risk-adjustment program for 2018
The rule released December 7, 2018 allows CMS to move on with the Affordable Care Act risk-adjustment program for the 2018 benefit year, even though litigation over the methodology is ongoing.
Article: CMS Reverses Decision to Halt Transfer Payments
The Trump Administration has reversed its decision on 2017 risk adjustment payments and will restart the program which pays about $10 billion to insurers to stabilize health insurance markets under the ACA.
GOP chairman in talks with Trump officials on restarting key ObamaCare payments
House Ways and Means Committee Chairman Kevin Brady (R-Texas) said that he is in talks with the Trump administration about ways to restart key ObamaCare payments that the administration abruptly suspended this month.
CMS Implications of the RA Decisions
CMS submits an announcement for implications of the decision by United States District Court for the District of New Mexico on the Risk Adjustment and Related Programs.
Risk Adjustment Lawsuit Fallout
Wakely Consulting Group shares information and perspectives on the recent CMS announcement about halting risk adjustment payments until litigation is resolved.
Risk Adjustment Rollercoaster
Michael Cohen, PhD of Wakely Consulting Group blogs about the recent announcement by CMS to halt risk adjustment payments and the implications.
Recording: 2017 ACA Transfer Payments - Reactions to Recent CMS Release
HealthScape Advisors & Pareto Intelligence as they provide insight into the recently released 2017 ACA transfer payment results.
Presentation: 2017 ACA Transfer Payments - Reactions to Recent CMS Release
HealthScape Advisors & Pareto Intelligence provide insight into the recently released 2017 ACA transfer payment results.
Preliminary Analysis of ACA Risk Adjustment Transfer Payments for 2017
Pareto Intelligence provides an analysis of the 2017 risk adjustment transfer payments status in light of the recent halt by CMS. An interactive state-level map of average metrics and transfer amounts are provided.