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Interactive Analysis: 2022 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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Fiona Dassum

Senior Data Analyst

Fiona Dassum is a Senior Data Analyst at Pareto Intelligence. She is responsible for developing, implementing, and supporting our end-to-end solutions. With a background in data analytics and information Systems, she delivers critical insights for our clients through her ability to interpret and handle data, assuring quality analysis and reporting.

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On June 30, 2023, the Department of Health and Human Services (HHS) unveiled the highly anticipated Summary Report on Risk Adjustment Transfer for the 2022 Benefit Year. This report dives into risk adjustment transfer payments by issuer and state for the Affordable Care Act (ACA) market. 

In an effort to simplify the data and enhance understanding, Pareto quickly ingested the data provided and developed the interactive analysis below, which includes year-over-year (YOY) comparisons of state average metrics, issuer transfer payments, and high-cost risk pool payments.

Risk Adjustment Transfer Payments

In the dashboard below, you will find a range of interactive buttons at the top that will guide you through the analyses and help you find answers to key questions including:

  1. How are state average metrics trending year-over-year?
  2. How do premium changes compare across different markets (by state)?
  3. How are high-cost risk pool payments correlated with transfer payments?
  4. How are transfer payments as a percent of premium changing in the Individual and Small Group market?
  5. What types of plans are capturing transfer payments (e.g., Nationals, Blues Plans, Provider-Sponsored)?
  6. How did transfer payments change year-over-year by issuer?

You can filter by year, state/region, metric, and/or risk pool/product (Individual or Small Group market).

Note: State average Plan Liability Risk Score (PLRS) cannot be compared YOY 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 allowing for a more accurate YOY comparison.

Conclusion

The above analysis summarizes HHS data to provide initial insight into the 2022 ACA risk adjustment transfer payment results. We’re dedicated to helping organizations grow, perform, and transform through professional consultancy and award-winning technology solutions.

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