In 2023, the total risk adjustment payments for individual and small group insurance plans saw a slight decrease relative to premiums, despite a higher overall amount of redistributed payments. Click here for article.
Increased Redistribution: CMS redistributed $10.3 billion in risk adjustment payments in 2023, up from $9.24 billion in 2022.
Slight Decrease in Share: Risk adjustment payments were 10.3% of premiums in 2023, a slight decrease from 10.4% in 2022.
Fewer Participants: The number of plans participating in the risk adjustment program decreased in 2023.
Cost and Risk Changes: The risk pool changed due to market expansions and special enrollment periods attracting healthier enrollees. Although per-member costs rose, the proportion of high-risk enrollees decreased.
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