PROJECTED BENEFIT COST TRENDS i. Description of the data, assumptions, and methodologies This section discusses the data, assumptions, and methodologies used to develop the benefit cost trends, i.e., the annualized projected change in benefit costs from the historical base period (CY 2014) to the CY 2016 rating period of this certification. We evaluated prospective trend rates using ODM, as well as external data sources.
PROJECTED BENEFIT COST TRENDS i. Description of the data, assumptions, and methodologies This section discusses the data, assumptions, and methodologies used to develop the benefit cost trends, i.e., the annualized projected change in benefit costs from the historical base period CY 2015 to the CY 2017 rating period. Total benefit cost trends were developed on a PMPM basis consistent with prior years’ certifications. The move to a utilization and unit cost approach is expected once encounter data can be used as the basis for the data. While the trends are illustrated on a PMPM basis, they reflect primarily utilization and mix/intensity of services. Unit cost trend is primarily handled through the program changes to reflect expected CY 2017 provider reimbursement.
PROJECTED BENEFIT COST TRENDS. This section discusses the data, assumptions, and methodologies used to develop the benefit cost trends, i.e., the annualized projected change in benefit costs from the historical base period (CY 2016) to the CY 2018 rating period of this certification. We evaluated prospective trend rates using ODM data, as well as external data sources. Total benefit cost trends were developed on a PMPM basis consistent with prior years’ certifications. The move to a utilization and unit cost approach is expected once encounter data can be used as the basis for the data. The trends are illustrated on a PMPM basis and primarily reflect utilization and mix/intensity of services. ODM-specific policy changes that impact CY 2018 provider reimbursement are handled through the program adjustments previously outlined.
PROJECTED BENEFIT COST TRENDS i. Description of the data, assumptions, and methodologies This section discusses the data, assumptions, and methodologies used to develop the benefit cost trends, i.e., the annualized projected change in benefit costs from the historical base period (May 1, 2013 to April 30, 2014) to the CY 2016 rating period. Total benefit cost trends were developed on a PMPM basis consistent with prior years’ certifications. The move to a utilization and unit cost approach is expected once encounter data can be used as the basis for the data. While the trends are illustrated on a PMPM basis, they reflect primarily utilization and mix/intensity of services. Unit cost trend, with the exception of the impact of case mix on NF per diem rates, is primarily handled through the program changes to reflect expected 2016 reimbursement.
PROJECTED BENEFIT COST TRENDS. This section discusses the data, assumptions, and methodologies used to develop the benefit cost trends, i.e., the annualized projected change in benefit costs from the SFY 2021 Experience Adjusted data to the July 1, 2022 through December 31, 2023 rating period of this certification. We evaluated prospective trend rates using historical experience for the MMC program, as well as external data sources.
