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Explore the 2018 ACA Risk Adjustment Transfer Payment Results

Austin Bostock

Director, Business Development

Austin is the Director of Business Development, focused on the implementation and delivery of Pareto’s solutions as well as ongoing industry advisory to various healthcare clients. His combined engineering and business backgrounds allows him to bring an analytical approach to solving problems and supporting revenue management improvement activities for clients.

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On June 28th, the Department of Health and Human Services (HHS) released the Summary Report on Risk Adjustment Transfers for the 2018 Benefit Year. This report outlines risk adjustment transfers by issuer and state. The interactive dashboards below provide initial insight and allows for year-over-year comparisons into state average metrics, issuer transfer payments, and high-cost risk pool payments. This post will be followed by an in-depth analysis of the 2018 ACA transfer payments and market trends.

2018 Benefit Year Risk Adjustment Transfers

Note: State average PLRS cannot be compared year-over-year due to adjustments to the CMS-HHS risk adjustment model coefficients. For this reason, Pareto has applied a reduction to all Prior Year State Average PLRS numbers in the analysis below, allowing for a more accurate year-over-year comparison.

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