Builders of both private and public exchanges are trying to figure out how to keep unreasonable amounts of health risk from rolling over some of the participants and burning them to a crisp.
Akshay Kapur, a management consultant at Booz & Co., and Ashish Kaura, a health services market specialist at the company, have been talking a lot about exchange risk-adjustment efforts in lately.
They’ve advised insurers, benefits firms and others about the implications of the Patient Protection and Affordable Care Act.
But one of the considerations that will affect whether those questions matter is whether the new exchanges even last.
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Whether the new exchanges last longer than the business insurance purchasing clubs of the 1980s may depend on whether the exchanges can keep players from predatory pricing.
“The entire marketplace depends on how well they do risk adjustment,” Kaura said.