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Actuarial Services

Publication Date
03/05/2018 03:22 PM EST
Closing Date
03/22/2018 05:00 PM EDT
Issuing Organization
University of Maryland Baltimore County
Solicitation Number

Specifications include, but are not limited to: i. Review of CY 2017 base per member per months (PMPMs) developed from health plans’ submitted HealthChoice Financial Monitoring Reports (HFMRs), including review of adjustments made by independent auditors and actuaries evaluating incurred but not reported claim reserves and review of adjustments made by the Hilltop. ii. Develop managed health care trend estimates and administrative cost inflation estimates. This includes analysis of HSCRC hospital data; encounter hospital, physician, and pharmacy data; year-over-year HFMR data by category of service; and trend information from other sources as appropriate (e.g. Maryland Insurance Administration filings, trends in neighboring states, Consumer Price Index, Producer Price Index, macro-economic indices, commercial health care marketplace indicators, etc.). For entire trend data period, incorporation of “claims lag” effects, where appropriate; nullification of programmatic changes; separation of encounter reporting improvement effects; separate identification of demographic shifts; aging and morbidity effects, where necessary; and other such adjustments necessary to estimate pure medical inflation not affected by other factors (normalized). iii. Incorporate population considerations in the development of trend estimates. With implementation of the ACA Medicaid expansion, provide analysis as needed to determine the appropriate adjustments to the CY 2020 rates for population changes. As needed, this may include requesting additional MCO reported experience to accurately evaluate durational trends.

https://emaryland.buyspeed.com/bso/external/bidDetail.sdo?bidId=MDR4131037391&parentUrl=activeBids (opens in a new window)

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