CMS to Freeze Risk Adjustment Payments to Health Insurers

MedPage Today

By: Joyce Frieden

The federal government will stop making risk adjustment payments to health insurers that have sicker-than-average patients, raising the specter of more premium increases by insurers to make up for the shortfall.

Withholding the payments will have both short-term and long-term effects, according to Edwin Park, JD, of Georgetown University. In the short term, “[the] potentially large financial hit on insurers expecting to receive [risk adjustment] payments, [will be] incorporated into their past & current premiums. [This] could affect 2019 premiums & marketplace participation,” he wrote on Twitter.

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