Health Fidelity, a healthcare technologies developer, has revealed that its risk analytics solution will also support risk adjustment for organizations participating in the ACA market.
The solution, which was introduced in March 2016, is used to support risk adjustment for Medicare Advantage plans and Medicare ACOs, and helps risk-bearing healthcare organizations improve their financial outcomes by measuring business performance and by optimizing prospective risk capture.
“Plans that offer ACA products face significant financial uncertainty and many have reported worse-than-expected results. This problem will become even more acute as the reinsurance and risk corridor components of the ACA expire,” said Steve Whitehurst, chief executive officer of Health Fidelity.
“This means that risk adjustment, the permanent component of the ACA, is critical to the financial viability of ACA lines of business. Plans remain in the dark about their risk adjustment transfer payments until the results are released the following year, when it’s too late to adjust strategy.
“Our Risk Analytics solution allows plans to continuously measure risk adjustment performance, estimate the potential impact to transfer payments throughout the year, and optimize risk adjustment efforts to ensure payments are commensurate to the population risk they bear.”
Health Fidelity, US, Insurance, Risk management, Risk analytics, Medicare, Healthcare, Steve Whitehurst, Technology, IT