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Considerations for Health Risk Adjustment in the Basic Health Program in Program Year 2015

This paper provides information for states interested in the Basic Health Program (BHP) option of retrospective risk adjustment. The Centers for Medicare & Medicaid Services (CMS) outlined in its final payment methodology issued on March 12, 2014 the process by which states can pursue this risk adjustment methodology. This paper provides more specifics about the certified methodology that CMS would require for risk adjustment calculations that would help adjust payments based on the differences in anticipated versus actual health status of the population in the BHP program.

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Founded by Former Congressman Jack Fields (R-TX), Twenty-First Century Group, Inc. is a bipartisan consulting firm specializing in Federal Government affairs. We provide strategic advice uniquely tailored to meet the individual needs of our Clients and help them navigate the complexities of political advocacy.

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Considerations for Health Risk Adjustment in the Basic Health Program in Program Year 2015