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Are Blues' Plans Benefitting Unfairly From Program To Offset Cost Of Sicker Patients?

For the first two years of exchange enrollment, Florida Blue received the most from risk adjustment — $705 million — based on a state-by-state review nationwide. Blue Shield of California was second with $317 million, and a unit of UnitedHealthcare in New York was next at $127 million. Overall, seven of the top 10 recipients for risk-adjustment dollars were Blues' plans for 2014 and 2015, federal data show. Blue Cross Blue Shield plans are major players in most state insurance markets, so their strong performance on risk adjustment could be expected. However, a separate analysis by the Fitch Ratings agency found that some of these top recipients also have higher-than-average administrative expenses companywide. http://www.healthleadersmedia.com/health-plans/are-blues-plans-benefitting-unfairly-program-offset-cost-sicker-patients?page=0%2C2#

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