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Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment”
Restoring the Indifference Ideal: If It’s Not Adjusting for “Risk,” It’s Not “Risk Adjustment” ACA risk adjustment is intended to "bridge the gap" between allowed rates and actuarial rates.- Authors: Greg Fann
- Date: Jun 2022
- Competency: Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Experience Studies & Data; Health & Disability>Health care
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2022-clinical-integration-medical-coding
The supplemental health market is changing. Carriers are looking to simplify claims processes, proactively identify missed claim opportunities, and reduce barriers to claim payment. As a result, ...- Authors: Society of Actuaries
- Date: Dec 2022
- Topics: Experience Studies & Data; Health & Disability; Technology & Applications
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2023-rx-reporting-caa
In late 2021, U.S. Congress passed the Consolidated Appropriations Act (CCA), which requires group health plans and health insurers to submit information regarding the costs of prescription drug ...- Authors: Michael Miele, Lina Chan
- Date: Nov 2023
- Competency: External Forces & Industry Knowledge
- Topics: Experience Studies & Data; Health & Disability