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Text of HHS-Developed Risk Adjustment Model Algorithm 'Do It Yourself' Software Instructions for the 2020 Benefit Year (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS] 
[Official Guidance] Aug. 5, 2020 24 pages; Aug. 3, 2020 update. "The methodology that HHS will use when operating a risk adjustment program on behalf of a State for the 2020 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 in order to determine risk adjustment payments and charges for plans within a State market risk pool." [Also available: Technical Details (XLSX); and 2019 Benefit Year Risk Adjustment: SAS Version of HHS-Developed Risk Adjustment Model Algorithm Software (ZIP)] |
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