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  #51  
Old 07-06-2016, 02:39 PM
New York Actuary New York Actuary is offline
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What really boggles my mind about these stories (Land of Lincoln and HealthyCT) is that these carriers had the some of the lowest rates in the market. You can expect that to attract the best risk. Why weren't they reserving for their payment into the RA programs?
Apparently it was difficult for some companies to come to the realization that setting prices somewhere around the state average premium was the best way to go. Clearly a mindset still exists that it is possible to win by figuring out a way to select risk.
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  #52  
Old 07-06-2016, 03:28 PM
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What really boggles my mind about these stories (Land of Lincoln and HealthyCT) is that these carriers had the some of the lowest rates in the market. You can expect that to attract the best risk. Why weren't they reserving for their payment into the RA programs?
What's unique about the healthy preferring lower prices? Don't sick people prefer low prices as well?

(If the low prices were accompanied by a lack of network options, then I can see the argument. I don't know or believe that this was the case here.)
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  #53  
Old 07-06-2016, 03:31 PM
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Clearly a mindset still exists that it is possible to win by figuring out a way to select risk.
This is likely still true; it's just the risk you want to select may be very different than pre-2014.
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  #54  
Old 07-06-2016, 03:53 PM
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What really boggles my mind about these stories (Land of Lincoln and HealthyCT) is that these carriers had the some of the lowest rates in the market. You can expect that to attract the best risk. Why weren't they reserving for their payment into the RA programs?
Not really, it could be inexperienced actuary underpricing the products. Despite lowest rate, they may not have the broker relationship to sell the product for low commission.
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  #55  
Old 07-06-2016, 06:46 PM
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A question of curiosity here, do MA insurers have a different risk adjustment program? What's going on over there?
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  #56  
Old 07-06-2016, 06:58 PM
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A question of curiosity here, do MA insurers have a different risk adjustment program? What's going on over there?
MA as medicare advantage or Massachusetts?

Massachusetts runs their own risk adjustment program.
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  #57  
Old 07-06-2016, 06:59 PM
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Massachusetts runs their own risk adjustment program.
Through the current year.
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  #58  
Old 07-06-2016, 07:08 PM
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MA as medicare advantage or Massachusetts?

Massachusetts runs their own risk adjustment program.

Yeah I meant to ask about Massachusetts. Care to share any reading material on what it is/how it works?
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  #59  
Old 07-06-2016, 10:29 PM
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What's unique about the healthy preferring lower prices? Don't sick people prefer low prices as well?

(If the low prices were accompanied by a lack of network options, then I can see the argument. I don't know or believe that this was the case here.)
Its not low premiums in isolation. I think that lowest-in-market premiums offered by a new, unknown market entrants should be expected to raise much scepticism among consumers, as it seems like the classic case of something that is too good to be true; purchasers should be wondering what the catch is. Sick consumers have way more to lose than healthy consumers if there does turn out to be some "gotcha," so it makes sense that fewer of them would take a gamble on the low premiums from the unproven companies.
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  #60  
Old 07-06-2016, 10:49 PM
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Yeah I meant to ask about Massachusetts. Care to share any reading material on what it is/how it works?
Link to Massachusetts model:


Short version: Similar to HHS model, but with different HCCs and weights for some of the factors. As noted Massachusetts is switching to the HHS model for CY2017.
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