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Transcript

This paper and the accompanying interactive exhibits allow the reader to review the coefficients from the 2019 model and compare how the EDGE data incorporated into the 2019 model will affect risk scores (which have a direct impact on an issuer's risk adjustment transfer). While future (2020 and later) risk adjustment models are unknown, it would not be unreasonable to assume that the weight assigned to EDGE data in creating the coefficients will increase; therefore, it would be prudent for ACA issuers to begin investigating how these model changes may influence their overall financial performance. To demonstrate the potential impacts from the new 2019 coefficients, ACA issuers would need demographic and condition prevalence data for their population(s). This would allow for an estimation of how their plan liability risk score (PLRS) might change from one period to the next. However, in order to understand the resultant impact to their estimated risk adjustment transfer(s), issuers would also need prevalence data for the total market(s) in which they operate. For the purpose of providing a hypothetical PLRS impact, we created a sample population using over 1.9 million individual ACA members from Milliman's 2016 Consolidated Health Cost Guidelines Sources Database (CHSD). The development of this population is described in more detail in the methodology section below.

Dummy text is also used to demonstrate the appearance of different typefaces and layouts, and in general the content of dummy text is nonsensical. Due to its widespread use as filler text for layouts, non-readability is of great importance: human perception is tuned to recognize certain patterns and repetitions in texts. If the distribution of letters and 'words' is random, the reader will not.

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