Managed Care Excess Loss (Actuarial Advisor: MCEL)
Actuarial Advisor: MCEL is the cutting-edge solution for pricing and managing modern managed care risk
There is a growing demand for excess insurance by medical providers. This demand is expected to increase as more hospitals and physician groups take risk as a result of incentives in the healthcare system and as providers position themselves to withstand pressures resulting from the expected concentration of bargaining power in fewer and fewer health insurance companies.
The complexity of the risk will grow as providers share risk on government programs including Medicare and Medicaid in addition to commercial enrollments.
- Actuarial Advisor: MCEL allows for a wide range of user inputs including detailed plan design, demographics, provider fee schedules, and trend. The Actuarial Advisor engine is built on a database containing millions of lives and billions of dollars in claims, sorted into detailed claim cost distributions.
- Actuarial Advisor: MCEL is logic driven using first dollar claim distributions obtained for each Medicaid sub-population as well as for Medicare and Commercial populations.
- Actuarial Advisor: MCEL offers significant advantages to anyone taking or evaluating managed care excess loss risk.
- Actuarial Advisor: MCEL is currently developed on a bespoke basis for specific markets.
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