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  #11  
Old 11-18-2009, 01:02 PM
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Originally Posted by BadBeatMe View Post
I agree that the count is in member-months but I disagree about credibility. The assignment specifically tells us that the experience is credible so I take that to mean that we should assume 100% credibility.
Valid point. My argument was to balance recent experience with the management and subject matter expertise that went into setting the ratings last year. Because of the disparity in some of the rating factors, I didn't want to fully use all the recent experience because it would significantly shift pricing parameters.
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Old 06-13-2010, 02:52 PM
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About Task 6A,

Under the experience data, are "Clms" the billed amounts or the paid amounts after cost sharing?

If they're billed amounts, then comparing the "Base PMPM" to the overall experienced PMPM seems like comparing apples to oranges, since one amount reflects cost sharing while the other does not (in addition to any differences in demographic mix).

Last edited by Atropellador; 06-13-2010 at 05:57 PM.. Reason: Removed some text after I realized my own mistake
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Old 06-13-2010, 03:55 PM
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One other thing:

I don't see any task that asks us to determine whether Petwell gained or lost money in its first year, and to identify the source of the gain or loss.

Do you agree? If not, do you believe we have the requisite data with which to perform such an analysis?
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