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Risk Adjustment Policy by the Federal Government
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The initial goal of risk adjustment was to make sure no carriers "cherry pick" customers and leave those with higher claim levels or lower income people who lack either knowledge about healthcare or the ability to afford wellness techniques unsnsured or insured at a higher rate. But the counter argument is that if you are a carrier who is aggressively manages your population and invests financially in wellness, nutritional programs and communication, specifically addresses the 10% responsible for over 50% of the claims, thus producing a lower loss ration why should you be penalized.. Risk Adjustment involves milllions of dollars and is one reason Minuteman Healh went out of business. What's the answer
Risk Management
Risk Analytics
Claims Management
Larry Ragland
68 months ago
68 months ago
0 answers
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