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CMS Tries to Keep the ACA Risk-Adjustment Program Moving

Your article was successfully shared with the contacts you provided. (Image: Thinkstock) The Centers for Medicare and Medicaid Services (CMS) is moving ahead with efforts to get the Affordable Care Ac... read more

Pathways To Success: A New Start For Medicare’s Accountable Care Organizations

The Shared Savings Program and requirements around it were established by law in the Affordable Care Act ... more similar to what is done in Medicare Advantage. And improvements in the methodology for ... read more

CMS tries more flexible rules to keep ACOs on board

The CMS offered more flexibility to Medicare accountable care organizations under a final rule published last week. The revisions are intended to maintain the program's rigor while ... three-year term ... read more

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Does the Trump administration's latest Obamacare attack help or hurt the ACA? Maybe both.

The risk adjustment ... according to CMS data, the biggest winners from the program were Blue Cross and Blue Shield plans. The point here is not that companies like CareFirst don’t need help to keep p... read more


To Fix the ACA, We Do Not Need a Public Option, We Need a Private Extraction

If we want to fix the ACA, we can't spend more federal dollars trying ... to keep it out of the final bill when the tide of support was moving lawmakers to include it. So, here we are again. Even Sena... read more

New Mexico Carrier Sues Over Feds' ACA Risk-Adjustment Move

(Related: CMS Tries to Keep the ACA Risk-Adjustment Program Moving) CMS officials argued, in an introduction to draft regulations, that adding an explanation to the old regulations should be enough to ... read more

KHN Morning Briefing

Modern Healthcare: UnitedHealthcare Loses New York Risk-Adjustment Battle UnitedHealthcare's New York subsidiaries lost a court battle against a state program meant to level ... power to sabotage the ... read more

States prepare to shut down children's health programs if Congress doesn't act

States forced to end the program will need to determine whether enrolled children are eligible for Medicaid or whether their family will need to seek insurance through an Affordable Care Act marketpla... read more

Freezing risk payments could upend stabilizing Obamacare markets, experts say

“Risk adjustment ... of the ACA,” tweeted former CMS Acting Administrator Andy Slavitt. “Impact likely chaos.” CMS has always calculated the payment based on the average statewide premium, believing i... read more

Health Insurers To See Risk Payments After All

The federal Centers for Medicare & Medicaid Services (CMS) on Tuesday abandoned its plan to stop collecting and making risk-adjustment ... keep things stable as part of the Affordable Care Act. The tr... read more

Changes to ACA exchanges may be enough to keep them afloat for now

The rule (PDF), which was released a couple of months earlier than expected includes changes in 2018 to the ACA risk-adjustment program as well as changes ... Before joining Modern Healthcare in 2015, ... read more

Medicaid recipients may stay in system even if they don't qualify

It's another problem exacerbated by the software that has been causing headaches since the exchange website launched on Oct. 1 for those trying to get into the expanded Medicaid program or buy ... und... read more



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