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December 18, 2012
16:36 EDTHNTHealth Net outlines commercial health cost expectations
The company expects the year-over-year change in commercial health care costs PMPM to be driven by several factors. The company anticipates no recurrence of adverse prior period development in 2013, which accounts for approximately 200 basis points of the change noted above. The continuing mix shift from larger to smaller groups, from higher cost to lower cost geographies, and from full network products to more efficient products with lower medical care ratios, is expected to account for approximately 90 basis points of the difference. Lastly, approximately 60 basis points of the difference are expected to result from repricing actions in the company’s largest accounts.
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