Commonwealth Care FY 2011 MCO Procurement Board of Director’s Meeting February 11, 2010. Agenda. FY 2011 Budget Summary Overview of Historical MCO Financial Performance Overview of Preliminary FY 2010 MCO Financial Performance Review of FY2011 Budget Assumptions: Enrollment Capitation Rate
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MCO Medical Margin After Risk Sharing, CY07 – FY09
MCO Total Medical Margin After Risk Sharing, CY07 – FY09
(1) Reports include claims incurred through Sept, paid thru Oct 2009 and incorporate a estimate for IBNR
(2) IBNR estimates for Network Health and Fallon were adjusted down to reduce excessive conservatism
+2.6% growth first half of FY10
7% increase Mar’09 – June’09
Financial results in FY09 were positive overall, but costs increased significantly late in the year.
Low increase in Q1 of FY10 may indicate moderation in cost trend, likely due to substantial new growth late in FY09.
* May be leading indicator of moderating medical cost trend
* Rx costs completes quicker than Medical
Quarterly change in age/gender score appears to be reasonable indicator of PMPM cost.
Specific Stop Loss Reinsurance:
MCO Administrative Fee:
Bidding and Payment: