Common use of Development of Projected Benefit Costs Clause in Contracts

Development of Projected Benefit Costs. i. Description of the data, assumptions, and methodologies This section of the report outlines the data, assumptions, and methodology used to project the benefit costs to the rating period. The baseline benefit costs were developed using the following steps: Step 1: Create per member per month (PMPM) cost summaries

Development of Projected Benefit Costs. i. Description of the data, assumptions, and methodologies This section of the report outlines the data, assumptions, and methodology used to project the benefit costs to the rating period. The baseline benefit costs were developed using the following steps: Step 1: Create per member per month (PMPM) cost summaries Step 2: Apply claims completion and care management adjustment Step 3: Develop regional adjustments

Development of Projected Benefit Costs. i. Description of the data, assumptions, and methodologies This section of the report outlines the data, assumptions, and methodology used to project the benefit costs to the rating period. The baseline benefit costs were developed using the following steps: Step 1: Create per member per month (PMPM) cost summaries Step 2: Apply historical and other adjustments to cost summaries Step 3: Blend base experience Step 4: Adjust for prospective program and policy changes and trend to calendar year 2017 (a) Managed care efficiency adjustments