Create integrated care organizations (ICOs)

Years 2–4 · UHADiscuss this step

ACA and Medicare Advantage risk adjustment

amendedYear 4Federal insurance & health law

Today

Transfers between insurers based on enrollee health; drives coding intensity.

Under the plan

Ends for insurers; retained only for integrated care organization budgets, with audits.

Trade-off

Removes most of the upcoding industry; risk-adjustment gaming can still occur for ICOs.