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Category Archives for Whitepapers

New study on Medicaid health plan margins from SOA

The Society of Actuaries has a new study out on Medicaid health plan margins. Its a comprehensive look at how health plans perform in the space, and a must read for anyone working in Medicaid finance.

Here’s the summary (full report is attached)

Medicaid Managed Care Organizations: Considerations in Calculating Margin in Rate Setting

The Society of Actuaries Health Section Research Committee is pleased to make available a research report that describes the components of margin for calculating capitation rates in a Medicaid context along with a description of practical issues that may be encountered by MCO’s. The report includes observations from interviews with MCO executives as well as financial results analysis of MCOs nationwide. The material was authored by Sara Teppema, Jeff Goldman, Luke Smith, and Steve Tutewohl from Valence Health.

 

medicaid-managed-report

 

You can also check out more on this report (including an appendix / data file in excel) here – https://www.soa.org/research-reports/2017/medicaid-margins/