Risk adjustment: Overview and opportunity: Top 10 notable issues related to the federal risk adjuster

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By Jordan Paulus, Mary van der Heijde | 25 August 2015
The federal risk adjustment program is set up to transfer funds from payers with lower-risk individuals to those with higher-risk individuals. In effect, the risk transfer program aims to normalize for the impact of differences in health status between carriers in a particular market. While simple in premise, the actual administration of the risk adjuster is complicated.