1. The parameters are attempting to improve the risk adjustment program through the development of policy.
2. HHS wants the risk program to compensate insurers for differences in enrollee health mix, so that plans premiums reflect the factors each patient brings to a plan.
“This allows fairer competition in the market and equalizes risk so that health plans can focus on competing on benefit design, quality efficiency and value rather than solely on price.”
3. The proposal has several recommendations. They include: incorporating prescriptions drugs into the model, considering better estimate techniques and removing administrative or other non-medical related costs from the formula.
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