And that disconnect has always been the knock. From day one, plans concentrated their enrollment in the high-paying markets. It isn't like this is a new problem. The low-paying markets were always there. But nobody moved into them until the last few years.
Riddle suggests looking at two issues in the low-paying markets.
The first and simple solution is paying the plans more money. But given current financial constraints, that's probably not a viable option. The second option is keeping HMOs out of low-paying markets to begin with. You'd say, 'Forget that. The Medicare program could do the same.