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  #11  
Old 05-22-2019, 10:00 PM
broosh35 broosh35 is offline
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Count me in as well. I started Project 1 about a week ago
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  #12  
Old 05-22-2019, 11:23 PM
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ChompChomp ChompChomp is offline
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Hey guys I started a Google group since there seems to be a lot of interest:
https://groups.google.com/d/forum/he...onomics-module

Please join and contribute
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  #13  
Old 05-26-2019, 05:35 PM
pianogirl94 pianogirl94 is offline
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So for Project 2 Task 1 Bullet 3 - they are asking for the breakeven PMPM which I assume is determined by considering some combination of the total claims that are targeted, the capitation payment received, and the shared/savings loss percentages. However, I have no idea how to use those to actually come up with what the PMPM should be - anyone have ideas?
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  #14  
Old 06-22-2019, 03:44 PM
jpierro21 jpierro21 is offline
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Default Health Economics Module

Quote:
Originally Posted by june3094 View Post
Anyone planning on starting Health Economics Module in next couple of weeks?
I started it today, and would be willing to collaborate with anyone.
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  #15  
Old 07-14-2019, 01:50 PM
HC1994 HC1994 is offline
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Project 1 Task 1 question,

I am a bit confused from the provided spreadsheet. Is the "Total Incurred Claims" (rows 45 to 61) inclusive of ER, UC, Imaging? I assume it is, and my assumption is that the in-network discount only applies to ER, UC, and imaging (am I wrong to assume this?).

If this is the case, how do I determine the % claim cost saved I could get from, say 1% increase in overall utilization of ER, UC, and imaging?
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  #16  
Old 08-14-2019, 09:48 AM
shady shady is offline
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Quote:
Originally Posted by HC1994 View Post
Project 1 Task 1 question,

I am a bit confused from the provided spreadsheet. Is the "Total Incurred Claims" (rows 45 to 61) inclusive of ER, UC, Imaging? I assume it is, and my assumption is that the in-network discount only applies to ER, UC, and imaging (am I wrong to assume this?).

If this is the case, how do I determine the % claim cost saved I could get from, say 1% increase in overall utilization of ER, UC, and imaging?
My assumption is that the total incurred claims include incurrals for all services (including ER, UC, and Imaging). I would also assume that the in-network discount applies to all in-network services (not just UC, ER, and Imaging), but I could be wrong too.

As for your second question, I would convert the ER, UC, and imaging amounts to a PMPM amount, then use that PMPM amount to evaluate changes in utilization. For example, the ER PMPM for Atlanta is $16.67, meaning that the total incurred for Atlanta without ER services is $436.13 ($452.80 - $16.67). You could then experiment from there with different ER PMPMs resulting from other ER utilization assumptions. For example, if I change the ER utilization/1,000 for Atlanta from 25 to 20, the ER PMPM becomes $13.33, bringing the total incurred for Atlanta to $449.47 ($436.13 + $449.47), which represents a 0.7% decrease in total incurred claims for Atlanta.
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  #17  
Old 08-14-2019, 10:00 AM
shady shady is offline
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I'm confused about how to apply the 7% trend in project 1. I initially assumed that we should decrease the total employer contribution by 7%.

For example (using made up numbers), if the current employer contribution is $100 and the employee contributions are $25, the employer responsibility is $75. I initially was trying to get the total employer responsibility to be <= $70.09 ($100/1.07), as this seems to be how the problem is worded in the project outline (i.e., "...reduce current benefit costs by 7%."). However, I realized this didn't make much sense and that it would be more intuitive to first trend the incurred claims by 7%, then make my changes such that the employer responsibility remains flat. In other words, my initial formula for the next year would be $107 - $25 = $82. So I would be making changes to the benefit plans, employee contributions, etc. to reduce the $82 back down to $75. What are everyone else's thoughts on this?
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  #18  
Old 08-17-2019, 02:31 PM
shady shady is offline
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It seems as though the coverage offered by BIG Company in project 1 is employee-only coverage and does not include coverage for dependents. Do people generally agree with this? I think it is employee-only coverage only because in the provided spreadsheet, the incurred claims PEPM are calculated as the total incurred claims divided by total average enrollment. This formula implies that total average enrollment = total employees and therefore coverage is employee-only.
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  #19  
Old 09-07-2019, 08:34 AM
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goodfella7763 goodfella7763 is offline
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Anyone get results recently? Submitted 8/1 and hoping it doesn't take too much longer.

Edit: MMR 9/12/2019

Last edited by goodfella7763; 09-13-2019 at 07:49 AM..
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  #20  
Old 09-15-2019, 10:57 AM
arc20 arc20 is offline
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Anyone currently working on this?
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