The instructors in this boot camp session will highlight the SOA's work on an updated Medicaid underwriting margin model. This research project includes an excel model, a set of instructions and a paper describing the key components of underwriting margin, including cost of capital and risk margin. The model was created as a tool for Medicaid actuaries representing both MCO and State principals to determine appropriate underwriting margin components within Medicaid managed care rates.
The session will begin with a brief description of the motivation for and underlying theory behind the model. Following this introduction, the instructors will walk through different model inputs and run through some realistic scenarios.
By attending this session, you will be able to:
- Understand the role that Medicaid underwriting margin plays in Medicaid rate setting.
- Understand the key components of Medicaid underwriting margin.
- Understand the factors that necessitate underwriting margins.
- Understand how to incorporate appropriate Medicaid underwriting margin levels in Medicaid rate setting.
- Learn how to leverage the model to assess different underwriting margin scenarios.
While significant guidance for Medicaid rate setting methodology exists through Actuarial Standards of Practice and the CMS final rate rule and annual updates, these references focus mainly on claims and administrative costs. The instructor's model provides additional guidance on underwriting margin methodologies and its development for inclusion in Medicaid managed care products.
Space is limited for this event!
Presenter(s)
Thomas M. Donlon, FSA, MAAA, FCA
Legacy 3 Consulting
Grant Porter
Director
Faulkner Consulting Group
Mardo Atoyan
Principal
Healthcare Analytics
Moderator(s)
Achilles M. Natsis, FSA, MAAA
Health Research Actuary
Society of Actuaries