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Changes Weighed for ACA Program Covering Sicker Patients
Bloomberg BNA 
Mar. 28, 2016
"Among the ideas covered were how to include high-risk patients in risk adjustment payments made by plans that have healthier enrollees, as well as including prescription drug information in the formula used to calculate the payments.... The discussion paper said the CMS is 'investigating whether the risk adjustment methodology appropriately addresses plan differences.' The transfer equation doesn't address network differences, plan efficiency or effective care coordination or disease management, it said."
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