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Wakely Releases ACA Risk Adjustment Estimates in 35 states

TAMPA, FLORIDA, UNITED STATES, May 24, 2018 / -- Wakely Consulting Group (Wakely) has released accurate estimates of risk adjustment transfers in 37 states^; approximately 45 days before CMS plans to release its final amounts^^.

As part of the Wakely National Risk Adjustment Reporting Project (WNRAR), Wakely provides participating insurance companies with periodic estimates of risk adjustment transfer amounts by risk pool. In addition, Wakely is able to provide these companies with estimates of the impact of annual model changes which are critical to business planning and financial forecasting. These estimates have proven to be remarkably accurate as a result of the hard work Wakely and WNRAR-participating companies have put into this important project.

Knowing these amounts is critical to managing insurance products in these complex and ever-changing markets. The risk adjustment program levels the playing field by transferring money from insurance companies that enroll healthy individuals to those that enroll sicker individuals. The risk adjustment amounts can be substantial to insurance companies’ financial results and it is important for companies to have good estimates as early as possible.

Chia Yi Chin, the actuary who manages the project, noted that “We have invested a lot of time and energy in refining our approach to vetting the insurance company data submissions and keeping up with CMS methodology changes. It has been really rewarding to see our hard work pay off.”
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About Wakely:
Wakely Consulting Group is a nationally recognized health care financial and actuarial consulting firm serving health plans, government regulators, employers, health care providers, and other stakeholders in health care, managed care, and reform markets. Wakely assists clients with product pricing, feasibility studies, predictive modeling, actuarial certifications and filings, operational analysis, compliance, and other financial and management aspects of their business. Wakely has offices in Tampa, FL; Denver, CO; Atlanta, GA; Minneapolis, MN; New York, NY and Phoenix, AZ.


^ 32 individual markets, 36 small group markets and 1 merged market.
^^ CMS intends to release the 2017 benefit year risk adjustment results by June 30th, 2018.

Kelly Thompson
Wakely Consulting Group LLC
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