28 pages. "The risk adjustment methodology that HHS will use when operating a risk adjustment program on behalf of a State for the 2023 benefit year will calculate a plan average risk score for each covered plan based upon the relative risk of the plan's enrollees, and apply a state payment transfer formula to determine risk adjustment payments and charges for plans within a State market risk pool. The methodology addresses three considerations: [1] adverse selection in the individual and small group (including merged) markets; [2] plan metal level differences and permissible rating variation; and [3] the need for risk adjustment transfers that net to zero." [Also available: [Technical Details (XLSX) and 2023 Benefit Year Risk Adjustment SAS Version of HHS-Developed Risk Adjustment Model Algorithm Software (ZIP)]  MORE >>