UPDATE HHS-Operated Risk Adjustment Methodology Meeting March 31, 2016 OPI Update UPDATE HHS-Operated Risk Adjustment Methodology Meeting March 31, 2016 9:00 a.m. – 4:30 p.m. ET CMS Headquarters, Baltimore, MD CMS will hold a public conference to discuss potential improvements to the HHS Risk Adjustment methodology for the 2018 benefit year and beyond. Send all correspondence to: RAOnsite@ardx.net REGISTRATION NOW OPEN!

What is CMS015 Risk Adjustment? Transfers funds from high-risk plans to low-risk plans Applies generally nationwide Why is CMS holding an Onsite? To solicit feedback on possible changes to the Risk Adjustment calculation methodology Each enrollee gets a risk score based on medical claims submitted to the DDC EDGE server Current calculations do not include pharmacy claims or historical diagnoses

Who at ARDX participates in preparing for the RA Onsite impact work at ARDX? Implementation Consultant (Theo) and OPI Director (Dot)- Project management and client communication Registrars and CXM: Event logistics, registration, remote access coordination, branding templates, transcription Content Team (OPI CMS015 RA Team): Slide development, quality control, post-session deliverables DRE: Collecting feedback and conducting evaluations

Looking Ahead: 2016 OPI Milestones Jan Feb Mar Apr May Jun – Jul Aug – Sep Oct – Nov Dec 2015 Data Collection Deadline RA Calculations Issuer Appeals HRADV IVA HIX8 820 Transaction Issued RI Payment Report RI Interim Payments CSR Reconciled Amounts Issued EDGE Server Maintenance Release Final Discrepancy Reporting RA Payment Report HIX 820 Transactions Issued: Monthly beginning 1/29/16 – 1/30/16 EDGE Server Maintenance Release: 2/26/16 RA Calculations: 1/9/2016 – 5/3/2016 RI Interim Payments Issued: 3/14/16 – 3/18/16 2015 Benefit Year (BY) Data Submission Deadline: 5/2/2016 Final Discrepancy Reporting Period: 5/3/2016 – 5/20/2016 Final RI/RA Payment Reports Issued: 6/30/16 Cost-sharing Reduction (CSR) Reconciled Amounts Issued: 6/30/16 Issuer Appeals: 7/1/2016 – 7/31/2016 HHS-operated Risk Adjustment Data Validation (HRADV) Initial Validation Audit (IVA) : 8/31/2016 – 12/31/2016