Common use of Assumptions and methodology Clause in Contracts

Assumptions and methodology. In developing the administrative costs, we reviewed the CY 2019 through first half 2021 cost reports and found a material amount of variation in the reporting of administrative expenses between the five MCOPs, both in the magnitude of administrative expenses and in the rate cell allocation methodology utilized. Cost report administrative expenses for both the Opt-Out and Opt-In MyCare programs were analyzed by MCOP for reasonableness and completeness of the data provided. For MCOPs with unreasonable administrative expense rate cell allocation, but reasonable total administrative costs, we reallocated their total administrative costs using the rate cell administrative expense distribution of the other MCOPs. This data formed the baseline for projected 2022 administrative expense amounts. Separate administrative expenses amounts were developed for each rating group. In addition, non-benefit expense amounts were developed with consideration for sub capitated administrative expense amounts included in MCOP cost report submissions.

Assumptions and methodology. In developing the administrative costs, we reviewed the CY 2019 2021 through first half 2021 2023 cost reports and found a material amount of variation in the reporting of administrative expenses between the five MCOPs, both in the magnitude of administrative expenses and in the rate cell allocation methodology utilized. Cost report administrative expenses for both the Opt-Out and Opt-In MyCare programs were analyzed by MCOP for reasonableness and completeness of the data provided. For MCOPs with unreasonable administrative expense rate cell allocation, but reasonable total administrative costs, we reallocated their total administrative costs using the rate cell administrative expense distribution of the other MCOPs. This data formed We then applied an annual trend of 3.5% to form the baseline for projected 2022 2024 administrative expense amounts. Separate administrative expenses amounts were developed for each rating group. In addition, non-benefit expense amounts were developed with consideration for sub sub-capitated administrative expense amounts included in MCOP cost report submissions.

Assumptions and methodology. In developing the administrative costs, we reviewed the CY 2019 2019, through first half 2021 2020 cost reports and found a material significant amount of variation in the reporting of administrative expenses between the five MCOPs, both in the magnitude of administrative expenses and in the rate cell allocation methodology utilized. . Cost report administrative expenses for both the Opt-Out and Opt-In MyCare programs were analyzed by MCOP for reasonableness and completeness of the data provided. For MCOPs with unreasonable administrative expense rate cell allocation, but reasonable total administrative costs, we reallocated their total administrative costs using the rate cell administrative expense distribution of the other MCOPs. This data formed the baseline for projected 2022 2021 administrative expense amounts. Separate administrative expenses amounts were developed for each rating group. In addition, non-benefit expense amounts were developed with consideration for sub capitated administrative expense amounts included in MCOP cost report submissions.