Total risk adjustment payments in individual and small group insurance plans increased in 2022, according to new data from CMS.
The agency redistributed $9.24 billion between insurers participating in the program in 2022, according to a risk adjustment summary report published June 30. The total payments increased from $7.03 billion in 2021.
The risk adjustment program is designed to even out financial risk between payers with higher and lower-risk enrollees in each market.
Risk adjustment payments as a share of premiums rose in 2022, according to the report, from 8.7 percent in 2021 to 10.4 percent in 2022. This could be driven by insurers moving into new markets, an increase in special enrollment periods and new subsidies to allow more people to enroll in ACA plans at lower costs, the agency wrote in the report.
Bright Healthcare had the highest share of individual risk adjustment payments, owing $1.9 billion in 2022, according to the report. The payer exited the individual insurance market at the end of 2022.
Friday Health Plans, which is in the process of winding down its business, owed $777.6 million in risk adjustment payments. Oscar Health owes $1.35 billion in payments.