A new analytics tool developed to better understand the drivers of financial performance in the Affordable Care Act market reveals that the sickest patients generate the most profit for insurance companies.
That may seem odd, but the ACA’s risk adjustment provisions are the reason why, says Syed Mehmud, principal and senior consulting actuary at Wakely Healthcare Actuaries. An actuary compiles and analyzes statistics and uses them to calculate insurance risks and premiums.
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