External Data Gathering Environment

Acronym: EDGE

The EDGE is one of the functional areas of the CMS-FFM project. The EDGE will receive, validate, store, and report on issuer medical and pharmacy claims, enrollee data and supplemental diagnosis code submissions. The data will be used to evaluate and perform Risk Adjustment (RA) including High Cost Risk Pool (HCRP) and Reinsurance (RI) calculations for issuers and other stakeholders.