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Mohave County trustees hear medical-claims review showing few high-cost members drive plan costs
Summary
Meritaine Health presented calendar-year 2024 claims data: overall per‑member costs fell slightly but a small group of very high‑cost claimants accounted for a large share of spending. Trustees discussed preventive care declines and network negotiations that produced deeper discounts.
Meritaine Health account director Rick Siphalmo told Mohave County trustees that calendar‑year 2024 produced mixed results: membership slipped 1.3 percent and employer per‑member‑per‑month costs were about 2.5 percent lower year‑over‑year, but claims utilization rose and a small number of very costly members continue to drive the plan’s expenses. "You had about 19 members that had claims over $100,000 which represents about 33 percent" of the plan’s medical spend, Siphalmo said.
The report compared two 12‑month periods rather than the county plan year to show trend. Siphalmo said the trust’s retrospective risk score was about 1.06 and…
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