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Health Foundations Module Old Health Systems Overview Forum

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Old 12-19-2018, 03:34 PM
Sarah02421 Sarah02421 is offline
Join Date: Aug 2008
Posts: 18
Default Task 2 EOM Exercise

Task 2 – Health Foundations Module EOM Exercise

Hello. The google group that I started has grown so large that we’ve decided to take our conversation back to the Actuarial Outpost. Below, I have copied all of the posts for Task 2. To make the conversation easier to follow, I’ve put “New Post” before each post. The conversation began on November 5, 2018. I hope you find the conversation as helpful as I have. Thanks.

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Here's a discussion for Task 2

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It seems like the expectation for this question is for us to recalculate all of the data elements that are used in the normalized trend calculation to arrive at the "correct" normalized trend.
I can see that there are some discrepancies with the member month counts & demo indexes from the MemTable tab, but does anyone know how deep we should go into the benefit indexes? I don't think we have enough detail to re-mix using the correct membership.
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I agree that we don't have the data to re-mix the benefit index with membership since the specific plan is not included in the membership data.

I think we can rerun the benefit index. The model feeds from the ABIS plan specifics but the ABIS plan specifics do not match the plan design from the product area. I'm assuming that the product area has the correct plan design.

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I see that now too, and I agree that the product area would probably have more benefit design information.
Is there anything missing from the ABIS grid other than the deductible for Plan E, and the add'l services copay/coinsurance for plans E & F?
Also did anyone else notice that the Plans D & E benefit indexes in the 'Benefit Index by Plan Report' table on the Summary tab weren't matching the Benefit Index Model calculations before making any changes?
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The 3 missing pieces in plans E & F were the only mistakes that I found in the ABIS data.

I also found that the benefit index on the Summary tab did not match the model output.

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I use two pages to reply this question, but I have noted that it ask us to write a "very brief" email.
what is your understanding about the adjective?

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Two pages is mostly like too long. My understanding is that you should present what the correct trend should be and then include a few sentences of what you included.

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I agree that 2 pages is too long. My response is 3 short paragraphs, just over half a page. I mention the changes I made and their effects then the new trend I calculated. And I finished with outlining a few limitations that remain.
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Old 05-10-2019, 05:52 AM
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Passacaglia Passacaglia is offline
Join Date: Jan 2006
Location: Chicago
Posts: 923

Anyone have thoughts about what membership numbers to use? I see three:

1. Top section of the summary tab
2. Bottom section of the summary tab (broken out by plan)
3. Sum at the bottom of MemTable (broken out by age)

Using 2 would balance to how the benefit index is calculated, 3 would balance to how the demo index is calculated. Maybe 1 is best after all, since it is supposed to match the "book of record for this field" (and if I use it, I don't need to decide between 2 and 3)

I could also add another reasonable possibility of taking the members in MemTable where Somestate is the contract state. I was hoping that it would match 2 and I'd be happy, but no. So I don't think it makes sense to use that, since then I'd have to recalculate the demo index using just those members.

I guess none of this really matters, since we're calculating a trend on PMPM, but it seems weird not to address this and put whatever is supposed to be right in there.
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Old 05-26-2019, 06:58 PM
BecauseDennisIssa BecauseDennisIssa is offline
Join Date: Oct 2018
Studying for how to be patient
Posts: 21

I saw the exact same issues on membership. Chose to NOT make any changes. Did not believe these would drastically change the result. Simply made a note about the possible issues, and how to address them in the future.

For demographic factors, i recalculated setting age 80+ to that of 70-79. Had only around a tenth of a percent impact.
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