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Claims rising slightly; pharmacy share and large claimants drive increases, consultant says
Summary
Consultant Chris reported trust claims running near budgeted levels but noted pharmacy costs are rising and a small number of large claimants account for a disproportionate share of paid claims. He highlighted utilization shifts tied to the district’s HealthiestU telehealth program.
Chris (consultant) delivered a claims update during the May 8 meeting, noting the trust’s most recent run rate and trends across plan tiers.
Chris said the trust is running at about 77% of expected liability year-to-date, similar to the prior year’s 78% at the same point. Pharmacy claims account for roughly 33% of total claims paid (up from 30% at the same time last year), which he attributed in part to certain high-cost specialty drugs returning to the…
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