Advancing the conversation on Medicare Advantage risk adjustment
Using encounter data collected from Medicare Advantage (MA) plans to re-estimate the MA risk adjustment model could make risk scores more accurately reflect the relative costs of providing care in MA. However, likely effects on the broader MA system are unclear.
Study offers new approach to identifying high-cost MA beneficiaries
While there is a growing focus on improving the quality of healthcare delivery for high-cost patients, research has mostly been focused on fee-for-service Medicare. New work is exploring the clinical composition of high-cost Medicare Advantage populations.
Costs are rising among Medicaid expansion enrollees
States and health plans have gained valuable experience with the Medicaid expansion population. While over 11 million individuals have gained coverage since the expansion began, relatively little has been shared publicly about the enrollment and utilization experience of expansion enrollees.
Anthem is pleased to support the Health Affairs Council on Health Care Spending & Value
The time is right for an evidence-based discussion about what we get for our health care spending, whether it is worth it, and what we might realistically do should we collectively determine that there are better ways to spend our limited resources.
Getting risk adjustment right in the individual market
The affordability and stability of premiums in the individual health insurance market figure prominently in the recent and ongoing debates over national health policy. Often overlooked in these debates is the role of risk adjustment and other risk-mitigation measures in promoting both objectives.
Enhancing state flexibility in Medicaid: Early lessons from Indiana HIP 2.0
Many states that expanded Medicaid, as well as many others that did not, are seeking greater flexibility to design their Medicaid benefits in a way that better serves the needs of their residents. They may learn from states like Indiana that have already implemented Medicaid reforms.