risk adjustment

Stakeholder Perspectives on CMS’s 2023 Notice of Benefit and Payment Parameters: Consumer Advocates

Posted March 7, 2022 by Emma Walsh-Alker

In the recently released 2023 “Notice of Benefit & Payment Parameters,” the Biden administration is proposing significant changes to the Affordable Care Act marketplaces. In the first of a three-part series, CHIR’s Emma Walsh-Alker and JoAnn Volk reviewed public comments from multiple consumer advocacy organizations about the impact of the new policies on marketplace beneficiaries. Reviews of comments from insurers and state marketplaces and insurance departments will follow.

The Draft 2022 Notice of Benefit & Payment Parameters: Implications for States

Posted December 4, 2020 by

On November 25, the Trump administration released a proposed regulation, the 2022 “Notice of Benefit and Payment Parameters.” It establishes policies governing the ACA marketplaces and insurance market reforms. In her latest article for the State Health & Value Strategies project, CHIR’s Sabrina Corlette focuses on several key provisions that will impact state insurance regulation and the operation of the marketplaces.

Stakeholders React to HHS’s Notice of Benefit and Payment Parameters for 2020. Part 1: Insurers

Posted March 21, 2019 by Emily Curran

On January 18, the Department of Health and Human Services issued its Notice of Benefit and Payment Parameters for 2020, which outlines the changes that it plans to apply to the Affordable Care Act marketplaces and insurance rules in the next plan year. The agency received over 26,100 comments on the proposal, including many from insurers, state-based marketplaces, departments of insurance, and consumer advocates. To better understand stakeholder reactions to the proposals, CHIR reviewed a sample of these comments, and, in Part I of this series, we summarize areas of support and concern from major medical insurers and associations.

The Proposed 2020 Notice of Benefit and Payment Parameters: Summary and Implications for States

Posted January 24, 2019 by

The U.S. Department of Health & Human Services has released a new set of rules and standards for the Affordable Care Act marketplaces and insurance provisions. CHIR’s Sabrina Corlette reviews the proposal and what its provisions mean for state insurance markets and coverage.

Look Past the Jargon and the Trump Administration’s Risk Adjustment Decision Ultimately Hurts People with Pre-existing Conditions

Posted July 11, 2018 by

The Trump administration recently decided to suspend payments under an obscure Affordable Care Act program called risk adjustment. The issue is technical and full of jargon, but at bottom it’s about undermining protections for people with pre-existing conditions. CHIR’s Sabrina Corlette explains why.

How the “3 Rs” Contributed to the Success of Medicare Part D

Posted January 27, 2014 by CHIR Faculty

Opponents of the Affordable Care Act are latching onto the law’s “3Rs” (risk corridors, risk adjustment, and reinsurance) as a “bailout” for insurers. Yet one of the models for the 3Rs is the Medicare Part D drug benefit, where these programs have been working for years to help stabilize premiums. Georgetown University Health Policy Institute’s Jack Hoadley provides some context – and strong evidence that the 3Rs are in place to protect beneficiaries and taxpayers – not bail out health plans.