Through the Wakely National Risk Adjustment Reporting (WNRAR) project, Wakely collected WNRAR participants’ 2016 Risk Adjustment Data Validation (RADV) results files ("issuer_metrics.csv") as issued by CMS. Using these results files, Wakely calculated market-level error rates by weighting issuers’ 2016 RADV error rates with their estimated 2017 total risk. Based on our survey sample of 61 markets, we estimated 47 markets to have a non-zero market error rate. These 47 markets would have had their 2017 risk transfers adjusted if the 2016 RADV program was implemented. It is important to understand that even if an issuer has a 0% error rate in their RADV results, their risk transfer would still be adjusted if other issuers in their market have non-zero error rates.
National Level Results of our Analysis