Project 2: Task 3

[Selina]

Discussions for project 2 task 3

[Sarah]

How did people come up with the anticipated reimbursement amount? If I assume that the HUB physicians are on the hook for all costs for their attributed members (e.g. inpatient hospital visits and emergency room visits in addition to traditional services provided in a PCP office), I do not have enough information to produce anticipated incurred claims since the average annual price/visit and average annual visits/member provided in the assignment are for PCP services only. Did people assume that the HUB PCPs are only responsible for the costs of PCP services?

[Chris]

I focused on the current FFS reimbursement vs the proposed cap arrangement and I also considered the savings generated through the things I had suggested in task 2. From there it was just a matter of adjusting the proposed arrangement to get it to be risk-neutral, and then suggesting a few other changes that I thought would be acceptable in the event that ATNAS wasn't willing to increase the cap payment.

[ashwag alzahrani]

I did recommend changes to the proposed arrangement.. Do we need to make calculation in this part? 

[Casey Drick]

Yes, you need to calculate your anticipated reimbursement amount

[Rida Wilton]

Anyone currently working on this?

Assuming that HUB can achieve the savings in Task 2, I am finding that their reimbursement under the proposed scheme is higher compared to the current FFS arrangement. Anyone making arbitrary assumptions on the shared savings component when deriving the "counterproposal"?

[Bring back AO]

Absolutely no clue here what to list for R&O except the actual development of medical inflation. Also no clue what other arrangement will be defensibly better than the prompt.