The risk adjustment payment uses statewide average premiums to draw money from health insurance plans within a state that have low levels of high-need patients and funnels that money to plans in that state with high amounts of high-need patients, as a way to minimize adverse selection and to spread risk.
The government was set to make a budget neutral payment of $10.4 billion for the 2017 plan year. But in a rare Saturday announcement, the agency said July 7 that the reason for putting the risk adjustment payments on hold was differing legal opinions on the validity of the payments.
This Week's Must Reads
Case studies shed light on treatment for rare form of MCL , Mori S et al. Clin Lymphoma Myeloma Leuk. 2019 Feb;19(2):e93-7.
Histopathological clues for differentiating follicular lymphomas, Servitje O et al. J Cutan Pathol. 2019;46:182-9.
Single agent daratumumab is not an option in B-cell lymphomas, Salles G et al. Clin Lymphoma Myeloma Leuk. 2019 Jan 2. doi: 10.1016/j.clml.2018.12.013.
Ibrutinib combo advances in CNS lymphoma, Grommes C et al. Blood. 2019;133(5):436-45.
Best frontline options for advanced follicular lymphoma, Shah NN et al. Clin Lymphoma Myeloma Leuk. 2019 Feb;19(2):95-102.
Must Reads in Practice Management
Over half of Americans support Medicare for All, Kaiser Family Foundation Health Tracking Poll – January 2019
Uninsured rate could rise with proposed premium calculator, Federal Register (84 FR 227)
No difference in financial distress with counseling intervention , Kircher SM et al. J Oncol Pract. 2019 Jan 9. doi: 10.1200/JOP.18.00270.
Many believe tumor profiling will benefit present treatment, Marron et al. JCO Precis Oncol. 2019 Jan 22. doi: 10.1200/PO.18.00176.
Physician mothers with extra caregiving at home at higher risk, Yank V et al. JAMA Internal Medicine. 2018 Jan 28. doi: 10.1001/jamainternmed.2018.6411.