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CMS Summary Report on Permanent Risk Adjustment Transfers for the 2020 Benefit Year (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]Link to more items from this source
July 1, 2021

40 pages. "Risk adjustment state transfers as a percent of premiums remained relatively steady compared to the 2019 benefit year.... The amount of paid claims remains strongly correlated with risk adjustment state payments and charges ... Risk scores decreased between 2019 and 2020.... The impact of the pandemic and how enrollees accessed healthcare was evident in the significant increase in telehealth usage, although there was only a slight increase in total paid claims costs when compared to the 2019 benefit year."

  • Appendix A: HHS Risk Adjustment Program State-Specific Data (XLSX)
  • Appendix B: HHS Risk Adjustment Geographic Cost Factor (GCF) (XLSX)
  • Appendix C: Issuer-Specific Information for Non-Merged Market Issuers (XLSX)
  • Appendix D: Issuer-Specific Information for Merged Market Issuers (XLSX)
  • Appendix E: Default Risk Adjustment Charge (XLSX)
  • Appendix F: Default Risk Adjustment Charge Allocation (XLSX)

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