Tag

Risk Adjustment

CMS-HCC risk adjustment models, RAF scores, and their impact on Medicare Advantage plan economics.

ACA Marketplace 2026: Subsidy Cliff, Enrollment Shock, and What Actuaries Need to Know

Enhanced subsidies expired, enrollment dropped to ~23M, median premiums up 18%, Aetna exited. Deep actuarial analysis of risk pool dynamics, adverse selection, state subsidies, and GLP-1 cost pressures.

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Medicare Advantage in 2026: What Actuaries Need to Know About the Market Shakeup

V28 risk adjustment, 2.9M forced disenrollments, benefit reductions, and the first enrollment decline in nearly 20 years. A comprehensive analysis for health actuaries.

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