Making Risk Adjustment Work in Health Care Reform: Identifying the Challenges and Potential Paths Forward

Risk adjustment will be a critical mechanism for ensuring the stability of the new health insurance exchanges that will begin in 2014 and achieving the promise of health reform with respect to expanded access to insurance coverage. Many decisions and activities will be needed, however, between now and 2014 and even beyond in order to put an effective risk mitigation system into place, requiring close collaboration between federal and state policymakers, health insurers and other stakeholders.

On February 14, 2011 NIHCM Foundaton hosted a meeting of experts at the L'Enfant Plaza Hotel in Washington, DC. This meeting brought together an outstanding group of 50 actuaries, economists, federal and state policymakers, health plan representatives, consultants and other stakeholders for a candid discussion of the challenges in developing and implementing risk adjustment under health reform and potential ways to address these challenges.