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The HHS-HCC Risk Adjustment Model for Individual and Small

Summary

Type of release
a one-off release of a set of related datasets

Data Licence
Not Applicable

Content Licence
Creative Commons CCZero

Verification
automatically awarded

Release Date
19 June 2015
Modified Date
4 September 2015
Publishers
U.S. Department of Health & Human Services
Keywords
claims, covered-services, eligibility, enrollment, expenditures, health-insurance-marketplace, hospital, inpatient, medicaid-expansion, medicare-advantage, national, outpatient, part-d, payments, physician-services, publications, quality
Identifier
the-hhs-hcc-risk-adjustment-model-for-individual-and-small
Landing Page
http://catalog.data.gov/dataset/the-hhs-hcc-risk-adjustment-model-for-individual-and-small
Maintainers
admin HealthData@hhs.gov
Language
en

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Description

Volume 4, Issue 3 of the Medicare and Medicaid Research Review includes three articles describing the Department of Health and Human Services (HHS) developed risk adjustment methodology under the Affordable Care Act (ACA). The ACA provides for a program of risk adjustment in the individual and small group markets using the HHS risk adjustment methodology, so as to compensate health insurance plans for differences in enrollee health mix so plan premiums reflect differences in scope of coverage and other plan factors, but not differences in health status. The methodology includes a risk adjustment model and a risk transfer formula. The article, Affordable Care Act Risk Adjustment - Overview, Context, and Challenges, describes the key program goal and issues in the HHS developed risk adjustment methodology and identifies key choices in how it responds to these issues, while The HHS-HCC Risk Adjustment Model for Individual and Small Group Markets under the Affordable Care Act, estimates differences in health risks taking into account the new population and scope of coverage. Risk Transfer Formula for Individual and Small Group Markets under the Affordable Care Act, describes how the transfer formula calculates balanced transfers intended to account for health risk differences while preserving permissible premium differences.

General Information

Legal Information

This dataset has been created by US Government which means it is required to be in the public domain. However US copyright law only allows open access by US citizens, we have assumed the data is equivalently licensed as CC0 for the rest of the world as this is in the spirit of the US Government’s Open Data policy.

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  • Find out how to contact someone about this data at

    http://catalog.data.gov/dataset/the-hhs-hcc-risk-adjustment-model-for-individual-and-small Do you think this data is incorrect? Let us know

  • Find out how to suggest improvements to publication at

    http://www.data.gov/issue/?media_url=http://catalog.data.gov/dataset/the-hhs-hcc-risk-adjustment-model-for-individual-and-small Do you think this data is incorrect? Let us know

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