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Health Insurers Warn of Market Turmoil as Trump Suspends Billions in Payments (nytimes.com)
6 points by rafaelc 3 months ago | hide | past | web | favorite | 1 comment



Dirty secret is/was that risk adjustment was often gamed by large insurers, so in that sense I agree it was a flawed program that disproportionately impacted small insurers with fewer resources to invest in a risk adjustment strategy and insurers with healthier than average populations which would have to pay into the program (which, combined with playing against "dirty" tactics used by large insurers probably meant overpaying into the program).

Health insurance is in general a weird business. People are dehumanized as a series of diseases. With risk adjustment insurers are literally trying to game these payments by trying to make you look sicker than you actually might be by chasing you down and coding you as having X or Y so they get more of these payments.




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