Payors and Providers Post-Pandemic
Raising Health
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Health Insurance - The New Methodology for Risk Adjustment
The big two changes will be the new methodology for risk adjustment to avoid upcoating and getting healthier people and then scoring them so you get a rebate. And the second is going to be the ability or willingness to let the Medicare enrollee themselves participate in this shared risk. The way insurers have handled shared risk is that they've said, because we're effective at sharing risk with providers, it means what we charge you next year for your premium will be lower. Those claims data are not readily accessible to the individual enrollee.
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