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- Our clients who represent governmental entities
include state health care plans for active employees and retirees,
Children Health Insurance Programs, and Medicaid programs.
- This work has involved the interaction with Boards
of Directors and Financial Boards in public forums while developing
successful long-term projections.
This work has included the assessment of proposed benefit
changes, cost-sharing arrangements, and provider reimbursement
changes.
- In addition, we have been engaged to work with several Robert Wood
Johnson financed initiatives. Most
recently, this includes the development of small employer health
care pools in a state. In
addition to developing the initial risk management structures and
pricing designs of the pool, we will be responsible for the analysis
of the actual experience and to propose changes, as necessary.
- For most governmental entities, the emergence of
both indemnity and managed care options, has left management the
additional responsibility to focus on the cost effectiveness of
multiple benefit design options which had not previously existed.
The major issues involved in this analysis include the cost
effectiveness of managed care organizations, the recognition of
health care risk selection of managed care enrollees, and the proper
pro-rata assessment of program costs to managed care.
- Our actuaries were instrumental in completing a
study sponsored by the Society of Actuaries and the National
Institute of Health with respect to health care characteristics of
the elderly. The actual
study can be found at www.soa.org.
- Our references are available with these clients.
Feel free to contact us.
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