Employers are becoming increasingly involved in the movement toward value-based reimbursement, particularly employers that self-fund the healthcare needs of their employees.

This paper analyzes the impact of insureds utilizing more elective services in 2017 out of fear of losing or having reduced coverage with the repeal of the Patient Protection and Affordable Care Act (ACA).

It is imperative that providers review their Medicare Advantage shared-risk arrangements annually, particularly shared-risk arrangements set up to span multiple years.

The impact of risk adjustment can be substantial, and health plans operating under the Patient Protection and Affordable Care Act (ACA) need a thoughtful and innovative plan for managing risk scores.

This article discusses common elements critical to analyzing and understanding shared risk and population-based arrangements.