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Considering trend guarantees in your next TPA selection analysis01 May 2019 - By Scott M. Cohen and Paul V. Sakhrani and Brian A. Sweatman - Article

There is increased interest from both employers and third-party administrators (TPAs) in incorporating medical trend guarantees into TPA selection analyses.

Pathways to Success: MSSP proposed rule: Integrity01 November 2018 - By Jason Karcher and Brian A. Sweatman - Article

This paper discusses ways in which accountable care organizations have been identified by the Centers for Medicare and Medicaid Services (CMS) as weakening integrity and how CMS is proposing to address concerns.

How will EDGE affect your 2019 ACA Risk Adjustment Transfer?02 August 2018 - By Zachary M. Davis and Phil Ellenberg and Brian A. Sweatman - Article

This paper and the accompanying interactive exhibits show the coefficients from the 2019 CMS HHS-HCC commercial risk adjustment model and compare how ACA experience from 2016 EDGE data incorporated into the 2019 model will affect risk scores, which have a direct impact on an issuer’s risk adjustment transfer.

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