No World Borders Publishes Affordable Care Act Risk Corridor Analysis

·2 min read

In 2020, the U.S. Supreme Court ruled on three cases brought by four insurers over whether insurers are entitled to $12.3 billion in unpaid risk corridors payments from 2014 to 2016. Now, after the House Approval of the American Rescue Plan Act, it is helpful to learn from history

NEWPORT BEACH, Calif., March 3, 2021 /PRNewswire/ -- No World Borders, Inc. announced that its CEO, Michael F. Arrigo published an analysis of risk corridors under the Affordable Care Act.

Michael Arrigo, healthcare data, regulatory and economics expert in medical coding and billing, HIPAA Privacy and Security, Electronic Health Records, health care intellectual property
Michael Arrigo, healthcare data, regulatory and economics expert in medical coding and billing, HIPAA Privacy and Security, Electronic Health Records, health care intellectual property

Michael F. Arrigo, C.E.O. of No World Borders, said, "With the House approval of the American Rescue Plan Act, it has approved broader subsidies. These subsidies are intended to insure more of the currently uninsured and encourage more states to expand Medicaid. The increase in the number of insureds increases the risk pool. The ARPA should encourage us to look back at the lessons learned when the Affordable Care Act started. When Health Insurance Exchanges were launched, insurers did not have the actuarial experience to estimate newly set premiums, risk rates and utilization. Risk corridors were intended to limit both the amount of money that a health insurance plan can make -- and how much it can lose -- during the first three years. In part, the intent was to encourage insurers to enter the HIE markets by mitigating their risk, "...to protect against the effects of adverse selection…" Once risk corridors were developed Congress refused to fund the program. This ultimately led to the lawsuit before the Supreme Court: Maine Community Health Options v. the United States."

The new retrospective analysis evaluates whether risk corridors benefit the insureds that the Affordable Care Act is designed to cover. Topics include:

  1. Risk Corridor Litigation Timeline

  2. History of Risk Corridors in the Affordable Care Act

  3. How Risk Corridor Calculations Work

  4. Risk Corridor Controversy

  5. Expected Benefits to the Consumer via Market Competition

  6. Using Medicare Part D as a Basis

  7. Actuarial Analysis of Costs and Benefits to Consumers and the Government in Plans with Risk Corridors

  8. Affordable Care Act Medical Loss Ratio (MLR) Standard

  9. Expenditures to Control or Contain Costs Such as Fraud are Excluded from MLR

About Michael F Arrigo

Michael F. Arrigo is the CEO of No World Borders, a healthcare data regulations and economics firm. He serves as an expert witness regarding the Affordable Care Act. In his work he also advises clients regarding risk adjustment in Medicare Advantage plans, Medicare Part D, and Accountable Care Organizations under the Affordable Care Act.

About No World Borders

No World Borders was founded in 2000. The company has a group of experts and technology focused on solving complex healthcare data, regulations, and economics and has offices throughout the U.S. The company news coverage and examples of client success stories are listed on its website.

(PRNewsfoto/No World Borders, Inc.)
(PRNewsfoto/No World Borders, Inc.)
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SOURCE No World Borders