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CMS Interim Summary Report on Individual and Small Group Market Risk Adjustment for the 2025 Benefit Year (PDF)
Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS] 
[Official Guidance] Mar. 16, 2026 "This interim summary report on risk adjustment is based on issuers submitting at least 90% of three quarters of claims data and 90% of enrollment data for the 2025 benefit year." [Also available: Appendix A: Interim 2025 Benefit Year Risk Adjustment State Averages with)State Billable Member Months (XLSX); and Appendix B: Interim 2025 Benefit Year Risk Adjustment Geographic Cost Factor (GCF) (XLSX)] MORE >> |
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