Risk adjustment, transitional reinsurance, and risk corridors are three critical risk mitigation provisions under the Patient Protection and Affordable Care Act (ACA). These impact how premiums are developed, how markets perform, and how the changes from the ACA impact carriers. The risk corridor program is a temporary feature that will apply to individual and small group qualified health plans from 2014 through 2016. It is not yet known which plans will qualify for a risk corridor program.
There are several interesting aspects of the risk corridor program, related to the formula and the wording. This article dispels some common misconceptions, demonstrates some of the less obvious aspects of the program, and should help plans better navigate healthcare reform.
Originally published in Health Watch, October 2013.