Required Elements. (i) Data The primary data used to develop benefit cost trends is historical claims and encounters from the covered populations. Data used for trend development included three years of cost and utilization experience, from CY 2015 through the base experience data period (CY 2017). External data sources that were referenced for evaluating trend rates developed from ODM data include: National Health Expenditure (NHE) projections developed by the CMS office of the actuary3, specifically those related to Medicaid. Please note that as these are expenditure projections, projected growth reflects not only unit cost and utilization, but also aggregate enrollment growth and enrollment mix changes such as aging. For trends used in this certification, we are interested only in unit cost and utilization trends, so in general, our combinations of unit cost and utilization trends should be lower than NHE trends. Express Scripts 2017 Drug Trend Report (February 2018)4. Other sources: We also reviewed internal sources that are not publicly available, such as historical experience from other programs and trends used by other Milliman actuaries.
Appears in 2 contracts
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan, Ohio Medical Assistance Provider Agreement for Managed Care Plan
Required Elements. (i) Data The primary data used to develop benefit cost trends is historical claims and encounters from the covered populations. Data used for trend development included three years of cost and utilization experience, from CY 2015 through the base experience data period (CY 2017). External data sources that were referenced for evaluating trend rates developed from ODM data include: ◾ National Health Expenditure (NHE) projections developed by the CMS office of the actuary3, specifically those related to Medicaid. Please note that as these are expenditure projections, projected growth reflects not only unit cost and utilization, but also aggregate enrollment growth and enrollment mix changes such as aging. For trends used in this certification, we are interested only in unit cost and utilization trends, so in general, our combinations of unit cost and utilization trends should be lower than NHE trends. ◾ Express Scripts 2017 Drug Trend Report (February 2018)4. ◾ Other sources: We also reviewed internal sources that are not publicly available, such as historical experience from other programs and trends used by other Milliman Xxxxxxxx actuaries.
Appears in 1 contract
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan
Required Elements. (i) Data The primary data used to develop benefit cost trends is historical claims and encounters from the covered populations. Data used for trend development included three years of cost and utilization experience, from CY 2015 through the base experience data period (CY 2017). External data sources that were referenced for evaluating trend rates developed from ODM data include: ◾ National Health Expenditure (NHE) projections developed by the CMS office of the actuary3, specifically those related to Medicaid. Please note that as these are expenditure projections, projected growth reflects not only unit cost and utilization, but also aggregate enrollment growth and enrollment mix changes such as aging. For trends used in this certification, we are interested only in unit cost and utilization trends, so in general, our combinations of unit cost and utilization trends should be lower than NHE trends. ◾ Express Scripts 2017 Drug Trend Report (February 2018)4. ◾ Other sources: We also reviewed internal sources that are not publicly available, such as historical experience from other programs and trends used by other Milliman actuaries.
Appears in 1 contract
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan
