2018 ACA Risk Adjustment Transfer Payment Results: “Premium Stabilization Program” Beginning to Stabilize
Austin Bostock,
On June 28th, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released the Affordable Care Act (“ACA”) Risk AdjustmentRead
Explore the 2018 ACA Risk Adjustment Transfer Payment Results
Austin Bostock,
On June 28th, HHS released the Summary Report on Risk Adjustment Transfers for the 2018 Benefit Year. Explore an interactive dashboard on the high level results.Read
Understanding the 2020 Medicare Advantage and Part D Rate Announcement & Final Call Letter
Brandon Solomon,
In April, the Centers for Medicare & Medicaid Services (CMS) released final policy and payment updates to the Medicare Advantage (MA) and Part D programs through the 2020 Rate Announcement and Final Call Letter. While there are many themes contained in the full document, one major takeaway stood out.Read
2018 ACA Risk Adjustment Interim Report: Huh, Yeah, What is it Good For?
Brandon Solomon,
Though there are challenges to interpreting the results of CMS’ annual interim risk adjustment report, the answer to the questionRead
Spotlight on the 2019 Medicare Advantage Annual Enrollment Period Results
Kristi Gemkow,
Using our Pareto Spotlight solution, Pareto aggregated and analyzed the final Annual Enrollment Period (AEP) results data to understand changes in enrollment and the impact of 2019 product strategies.Read
What is the Impact of Expanded Supplemental Benefits in Medicare Advantage?
Brandon Solomon,
Beginning in performance year 2019, CMS awarded Medicare Advantage Organizations (MAOs) greater benefit flexibility through the creation of newly accepted (or expanded) supplemental benefits. January 2019 enrollment provides our first look into how the market reacted to the new benefit offerings.Read
Navigating the Medicare Advantage Competitive Landscape in 2019
Brandon Solomon,
At the start of Q4, CMS gives Medicare Advantage Organizations (MAOs) their first look at what the MA competitive landscape will look like in the following year. Leveraging our Market Spotlight solution, Pareto immediately ingested these files and uncovered key insights for MAOs within the data.Read
Attack of the Clones: Using Clone Analysis & Predictive Algorithms to Profile Newly Enrolled Members
David Thompson,
Regardless of the extent of clinical and historical data available, there are irrefutable benefits to applying analytics to garner information about an unfamiliar population. Using a limited dataset, Pareto applies proprietary models to profile new-to-plan members.Read
2017 Risk Adjustment Transfer Payment Results: Same Game, Different Outcomes
Austin Bostock,
CMS released the Affordable Care Act (ACA) Risk Adjustment Transfer Payment results for the 2017 benefit year. Year-over-year gross transfer dollars increased 2% nationally across the Individual and Small Group risk pools but range from -99% to 1000+% across state markets.Read