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Measuring employer cost savings from network changes25 May 2016 - By Hans K. Leida and Shyam Kolli and Troy J. Pritchett - Article

This paper discusses risk-adjusted allowed costs in the context of large self-insured employers that are looking to identify efficient providers and directly contract with them to reduce costs and/or improve employee health outcomes.

Ten potential drivers of ACA premium rates in 201702 December 2015 - By and Hans K. Leida and Lindsy Kotecki - Article

The rate-setting process remains a complex and challenging task for health insurance issuers.

Transitional reinsurance at 100% coinsurance: What it means for 2014 and beyond24 June 2015 - By Daniel J. Perlman and Doug Norris and Hans K. Leida - Article

The 2014 transitional reinsurance program will have a coinsurance rate of 100% rather than 80%, and this has implications for the final 2014 financial results of issuers of individual and small group market plans that comply with the Patient Protection and Affordable Care Act.

Catching up with Hans Leida15 April 2015 - By Hans K. Leida - Article

Hans Leida talks about innovation in predictive modeling, particularly in the area of risk adjustment models.

2016 HHS risk adjuster coefficient updates10 March 2015 - By Hans K. Leida and - Article

Updates to the risk adjustment model coefficients are intended to reflect more current treatment and cost patterns.

Risk adjustment and shared savings agreements16 January 2015 - By Hans K. Leida and Leigh M. Wachenheim - Article

Risk adjustment, a driver in claim costs, needs to be better understood given its impact.

Risk corridors episode IV: No new hope18 December 2014 - By Daniel J. Perlman and Doug Norris and Hans K. Leida - Article

The rules surrounding risk corridors are continually evolving and uncertain.

How consumers might game the 90-day grace period and what can be done about it17 November 2014 - By Hans K. Leida and Michael Kolber - Article

Under the ACA, individuals receiving a federal subsidy for health insurance are entitled to a three-month grace period. Find out ways consumers might game this provision and what can be done about it.

Canceled plans, part III: An extension, an expansion, and more changes to 2014 rules25 March 2014 - By Hans K. Leida - Article

Premium rates filed for 2014 might not cover claims costs if healthier individuals retain their noncompliant plans rather than seeking coverage in the ACA complaint market.

Update on canceled plans: Will changes to 2014 reinsurance and risk corridor programs provide financial relief?27 January 2014 - By Doug Norris and Hans K. Leida - Article

What do the healthcare reform changes announced in November 2013 mean for insurers?


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