These weights are the simple mean expenditures per member per month
within each ACG divided by the grand mean (per member per month
) across all ACGs; these are based on pooled Medicaid and private sample data in each State.
Step 7: Calculate price per member per month
. The price per member per month
equals the product of average tests per collection multiplied by the average number of collections per year divided by 12.
* Capitated Financing: A capitated payment (i.e., per member per month
) is typically obtained from Medicare and Medicaid, although some enrollees who are not financially eligible for Medicaid do pay privately for some of the care.
The utilization of acute care hospital beds appears excessive when compared to that obtainable with managed care for Medicare or commercial insurance beneficiaries-the cost per member per month
is three times higher.
The state expenditures per member per month
for all health services (outpatient, inpatient, and specialty care) were less for PCMP than for the full capitation models (P[less than].10).
Towncrest saved the organization $300 per member per month
for more than 600 beneficiaries.
The average amount of premium per member per month
fell to about $224 in the fourth quarter, from an average of about $252 for the year.
As a result of a separate Letter Agreement signed on January 14, 2015 to reflect an adjustment in co-payments, ASES will pay Triple-S a revised rate per member per month
of $174.16 for the Metro North Region and $140.61 for the West Region.
Roth pointed to a 2012 study in which the authors performed an actuarial analysis showing that offering lung cancer screening as an insurance benefit for the general population would cost about $1 per member per month
in 2012 dollars, and that the cost per life-year saved would be below $19,000, which compares favorably with the cost of screening for colorectal, cervical, and breast cancers.
In 2007, the adjusted cost per member per month
of plan members with diabetes who were commercially insured was $923 among those who received diabetes education, compared with $1,072 among those who did not.
It found that medical office-based claims were lower by $1.92 per member per month
, and that total healthcare claims were reduced by more than $3 per member per month
for those with access to the RelayHealth service.
Expanded mental health parity will cost employers a 1% increase in health plan costs, or an additional $1.32 per member per month
, according to a PricewaterhouseCoopers actuarial analysis of the Mental Health Equitable Treatment Act of 2001 (S.