New York Recommendations for Reinsurance and Risk Adjustment Under the ACA

New York held a stakeholder meeting to review the recommendations of Wakely Consulting Group relating to risk adjustment and reinsurance mechanisms under the ACA. Wakely recommended that New York administer its own risk adjustment model given its experience in administering risk mitigation programs, its strong regional variations, and its existing work toward an All Payor Claims Database (APCD). They also recommended the state consider a transitional approach  until the APCD is complete.

At the same stakeholder meeting, New York outlined key state decisions in response, agreeing that the long‐term goal was for the state to conduct risk adjustments based on Clinical Risk Groups (CRGs) methods applied to the APCD and outlining transitional approach options.

To access the Wakely presentation click here.

To access NY's key state decisions slide click here.