Risk Adjustment. An actuarial tool used to calibrate premiums paid to Health Benefits Plans or carriers based on geographical differences in the cost of health care and the relative differences in the health risk characteristics of Enrollees enrolled in each plan. Risk adjustment establishes premiums, in part, by assuming an equal distribution of health risk among Health Benefits Plans in order to avoid penalizing Enrollees for enrolling in a Health Benefits Plan with higher than average health risk characteristics.
Appears in 9 contracts
Samples: Qualified Health Plan Contract, Covered California Qualified Health Plan Contract, Qualified Health Plan Contract
