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The team at srHS has over 65 years of experience
developing actuarially certified rates for both public and private payers. We have developed actuarially sound rates for the following types of
populations:
- Medicaid programs
(Temporary Assistance for Needy Families, Aged/Blind/Disabled, General
Assistance),
- Children’s Health
Insurance Programs (CHIP),
- Medicaid expansion
programs,
- Large employer groups,
- Provider groups, and
- Health Care Reform
programs.
These rates can cover all types of
services (acute, ambulatory, long-term care, behavioral health, dental,
pharmacy) for various types of managed care contractors (HMO, EPO, PPO). Our proven
process includes requesting and analyzing data, calculating impact of
programmatic changes, deriving trend assumptions, and building estimates for
non-medical costs (administration, profit, risk and contingencies).
Our actuaries utilize CMS's rate development checklist in developing all rates/premiums as well as any applicable actuarial standards of practice and state laws. We also
provide an actuarial certification documenting our methodology and final rate
ranges that comply with CMS’s requirements for Medicaid and expansion programs.
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