24 pages. "The methodology that HHS will use when operating a risk adjustment program on behalf of a State for the 2018 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 payment transfer formula in order to determine risk adjustment payments and charges for plans within a State market risk pool. The HHS risk adjustment methodology addresses three considerations: [1] adverse selection in the individual and small group 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 file, 976KB] 2018 Benefit Year Risk Adjustment SAS Version of HHS-Developed Risk Adjustment Model Algorithm Software (.zip file, 1MB)]

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