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View Full Version : 8GM - 209 - Utilization Adjustment Model


Not Mike
10-23-2002, 11:22 PM
OK, the Choice model and choice-based cost curve are relatively straightforward, but I can't figure out this other one at all....

Anyone have any ideas? The example in the appendix just seems to pull numbers out of the blue...

one specific example:

The 31.50 Total cost for Hosp IP has a 16.9% Member cost share under Plan 3, and a 12.3% cost share under the base plan. Where the heck do these numbers come from... given no OOPM in the plan provisions, and a 20% coins, member cost share should be, AT MINIMUM, 20% (but presumably even higher since there's a ded)...

Anyone figure this stuff out??