Common use of Completion adjustment Clause in Contracts

Completion adjustment. The capitation rates are based on CY 2019 experience. Encounter data is paid through March 31, 2020. Completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using Milliman’s Robust Time-Series Analysis System (RTS)2. First, we stratified the data by category of service and population grouping. Claims for each of these population- service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCP reported IBNP liability estimates in the CY 2019 MCP Cost Reports for reasonableness. The monthly completion factors were applied to CY 2019 experience to estimate the remaining claims liability for the calendar year. Results were aggregated into annual completion factors for each calendar year.

Completion adjustment. The capitation rates are based on CY 2019 2016 experience. Encounter data is paid through March 31, 20202017. Completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using Milliman’s Robust Time-Series Analysis System (RTS)2. First, we stratified the data by category of service and population groupinggroupings. Claims for each of these population- population-service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCP reported IBNP liability estimates in the CY 2019 2016 MCP Cost Reports for reasonablenessReports. The completion factors selected were developed by blending MCP reported IBNP with our IBNP estimates. The monthly completion factors were applied to CY 2019 2016 non-sub-capitated experience to estimate the remaining claims liability for the calendar year. Results were aggregated into annual completion factors for each calendar year. For the AFK population, completion factors were developed through a review of historical fee-for-service claims experience.

Completion adjustment. The capitation rates are based on CY 2019 2018 experience. Encounter data is paid through March 31, 20202019. Completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using Milliman’s Robust Time-Series Analysis System (RTS)2. First, we stratified the data by category of service and population grouping. Claims for each of these population- service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCP reported IBNP liability estimates in the CY 2019 2018 MCP Cost Reports for reasonableness. The monthly completion factors were applied to CY 2019 2018 experience to estimate the remaining claims liability for the calendar year. Results were aggregated into annual completion factors for each calendar year.

Completion adjustment. The capitation rates are based on CY 2019 2017 experience. Encounter data is paid through March 31, 20202018. Completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using through the use of Milliman’s Robust Time-Series Analysis System (RTS)2. First, we stratified the data by category of service and population groupinggroupings. Claims for each of these population- service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCP reported IBNP liability estimates in the CY 2019 2017 MCP Cost Reports for reasonableness. The monthly completion factors were applied to CY 2019 2017 experience to estimate the remaining claims liability for the calendar year. Results were aggregated into annual completion factors for each calendar year.

Completion adjustment. The capitation rates are based on CY 2019 2016 experience. Encounter Cost report data is paid through March 31, 20202017. Completion factors were developed by summarizing encounter cost report data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using Milliman’s Robust Time-Series Analysis System (RTS)2. First, we stratified the data by category of service and population groupingservice. Claims for each of these population- population-service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCP MCOP reported IBNP liability estimates in the CY 2019 MCP 2016 MCOP Cost Reports for reasonablenessReports. Although the completion adjustments were similar, we elected to apply completion adjustments based on our calculated IBNP liabilities rather than the IBNP liabilities reported by the MCOPs. The monthly completion factors were applied to CY 2019 2016 non-sub-capitated experience to estimate the remaining claims liability for the calendar year. Results were aggregated into annual completion factors for each calendar year.

Completion adjustment. The capitation rates are based on CY 2019 2018 experience. Encounter data is paid through March 31, 20202019. Completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using Milliman’s ▇▇▇▇▇▇▇▇’▇ Robust Time-Series Analysis System (RTS)2. First, we stratified the data by category of service and population grouping. Claims for each of these population- service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCP reported IBNP liability estimates in the CY 2019 2018 MCP Cost Reports for reasonableness. The monthly completion factors were applied to CY 2019 2018 experience to estimate the remaining claims liability for the calendar year. Results were aggregated into annual completion factors for each calendar year.

Completion adjustment. The capitation rates are based on CY 2019 2017 experience. Encounter data is paid through March 31, 20202018. Completion factors were developed by summarizing encounter data and applying traditional actuarial techniques to develop estimates of incurred but not paid (IBNP) liability, using Milliman’s through the use of ▇▇▇▇▇▇▇▇’▇ Robust Time-Series Analysis System (RTS)2. First, we stratified the data by category of service and population groupinggroupings. Claims for each of these population- service category stratifications were analyzed and formed into lag triangles by paid and incurred month. Claim completion factors were developed for each month of the base experience period, based on historical completion patterns. Completion factors developed through the use of encounter data were compared to MCP reported IBNP liability estimates in the CY 2019 2017 MCP Cost Reports for reasonableness. The monthly completion factors were applied to CY 2019 2017 experience to estimate the remaining claims liability for the calendar year. Results were aggregated into annual completion factors for each calendar year.