First introduced in 2014 as part of the Affordable Care Act (ACA), commercial risk adjustment aims to create a level playing field for plans serving members with higher-than-average risk scores and needs. This is accomplished through a risk transfer formula enabling monetary transfers from lower-risk plans to higher-risk plans within the same market.  

For the 2023 benefit year, the absolute value of all transfers totaled nearly $ 20.6 billion, meaning $ 10.3 billion was charged to plans with lower risk scores and $ 10.3 billion in payments was received by plans with higher risk scores. 
Cotiviti Blog